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Full text of "Peoria Medical Monthly (1880-1891)"

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BRADLEY UNIVERSITY LIBRARY 



3 1272 00528 9010 



Digitized by tine Internet Arcliive 

in 2010 witli funding from 

CARLI: Consortium of Academic and Researcli Libraries in Illinois 



http://www.archive.org/details/peoriamedicalmon03peor 



VOLUME III. 



1882-1883. 



THE PEORIA 






A PRACTITIONER'S JOURNAL 



THDS, M, McILVAINE, A, M,; M, B,, 
Editor and PublishEr, 



ointe idohiXj-^i^ i=ei^ ..^isrnsrxjiM:. 



PEDRIA, ILL.i 

IsTn, 2n4 Snuth-JEffErsnn StrEEt, 

1BB3, 



(oOETRIBUTORS TO VOLUME III, 



Dr. 


^. ^. ^//en, 


III. 


Dr. 


L. L. Leeds, 


III. 




a 


S. T. Anderson, 


ii 


(( 


T. H Line, 


(( 




(( 


H. S. Bell, 


n 


n 


C. B. Maclay, 


« 




a 


Rob't Boal, 


ti 


(( 


Katharine Miller 


> 




« 


Wm. A. Byrd, 


(( 


<< 


W. S. Newton, 


Kan. 




(( 


G. W. Carpender 


, Ind. 


.< 


H. Nance, 


III. 




a 


Chas. H. Carter, 


111. 


(( 


R. A. Pinkley, 


" 




ti 


W. J. Cheonweth 




<( 


J Payne, 


it 




a 


A. S. Core, 


« 


u 


0. P. Paulding, 


i( 




(I 


R J. Ciirtiss, 


<( 


" 


G- B- Parsons. 


Neb. 




(< 


B. Daley, 


Kan. 


" 


Rob't Roskoten, 


III. 




n 


F. Drude, 


III. 


a 


R. B. Ray, 


t( 




<( 


J. D. Ebert, 


Ind. 


(( 


J. A. Robinson, 


u 




<( 


Jos. C Frye, 


III. 


u 


J. Richardson, 


Iowa. 




u 


I. J. M. Goss, 


Ga. 


<t 


F. L. Searles, 


a 




<( 


J. L. Hamilton, 


III. 


U 


H N. Sill, 


<( 




a 


0. E. Herrick, 


Mich. 


(< 


A. R. Small, 


III. 




" 


J. M. Hole, 


Ohio. 


(1 


F. E. Sherman, 


« 




<( 


N. Holton, 


III. 


(( 


B. Stephenson, 


Iowa. 




<( 


S. Hubbard, 


(( 


(< 


J. A. Stites, 


Nev. 




<< 


S. F Hurst, 


<( 


(( 


S. A. Suloff, ' 


Penna. 




i( 


G. N. Jennings, 


« 


<< 


W. H. Veatch, 


III. 




i< 


D. N. Jones, 


Minn. 


(( 


0. B. Will, 


(( 





Transcript Job Printing House, Peoria. 



TABLE OF CONTENTS--Y0L III, 



ORIGINAL COMMUNICATIONS. 

Page. 

Abscesses of the Perinaeum and Ischio Rectal Region 12 

Acne 48 

Acute Nephritis Following Scarletina 20 

Acute Diabetes Mellitus with Albuminuria 189 

Adenoid Tumors — Electricity for 6 

Amalgam Poisoning 229-271 

Amaurosis — Electricity for 49 

Amenorrhoja — Electricity for 49 

An Unexpected Result 22 

Bacteria 309 

Best Methods in Practice 147 

Bichromate of Potassium in Syphilis 57 

Catheters— Look Out for Your Soft 396 

Changes in Medical Legislation — Necessity for 17 

Chromophytosis — Electricity for 47 

Chronic Gastric Ulcer 386 

Clinical Contributions to Electrical Therapeutics 4, 41 

Clinical Uses of the Microscope Curtiss 464 

Codia 59 

Compensation to Physicians 361 

Congenital Fibroma of the Foot — Case of 236 

Congestion and Induration of the Mammary and Axillary Glands— Case of. . . 239 

Conulsions of Childhood — The Stomach Pump in 145 

Cystic Tumors — Electricity for 5 

Dental Plagiarism or Amalgam Poisoning 229, 271 

Difficult Labor and Fcttal Monstrosity 424 

Duties of Physicians to Medical Societies 77 

Duties of the Public to the Medical Profession 82 

Dysentery — Treatment of 201 

Eczema — Electricity for . 48 

Electricity in the Relief of Pain 23 

Electrolysis 4 

Electrical Therapeutics — Clinical Contributions to 4, 41 

Encephaloma — Electricity for 7 

Erectile Tumors — Electricity for 8 

Facts Concerning Nasal Catarrh 107, 151 

Fibroid Tumors — Electricitj' for ' 9 

Foreign Bodies in the Bronchi Simulating Phthisis; Death from Hem- 
orrhage and Exhaustion Sill 474 

Hemorrhoids — Treated by Forcible Dilatation, etc 149 

Herpes — Electricity for 48 

Herpes Zoster Vel Zona 54 

Hog Lard the Sine Qua Non for Scarlet Fever 423 

Hypodermic Syringe — How to Keep it in Order 22 

Indurations — Electricity for 51 

Intestinal Obstructions 350 

Labor Delayed by Retained Placenta 323 

Lead Poisoning — Electricity for 50 

Local Atrophy — Electricity for 53 

Look Out for Your Soft Catheters 396 

Lumbago— Electricity for 50 

Medical Legislation — Necessity for Change in 17 

Michigan University Trouble 359 

Molar Pregnancy — An Anomalous Case 1 

Morbid Adhesion of the Placenta with Laceration of the Funis Umbilicalis 

— Complicated with Hour-glass Contractions 101 

NsBvi Materni 52 



iv Tnif Peoria Medical Monthly. 

ORIGINAL COMMUNICATIONS— Continued. 

Page. 

Nasal Catarrh— Facts Concerning 107, 151 

Necessity for Change in Medical Legislation 17 

New Uses of Old Remedies 57 

Nitro-Glycerine ^ 

On the Resources for Meeting Emergencies IJ^ 

Ovarian Irritation ^1^ 

Ovarian Tumor— Successful Removal of 1U> 

Past and Present— Then and Now 62 

Peculiar Case Peculiarly Handled 241 

Preserves— A " Recipe " with a Preface oJ7 

Practical Hints From Every-day Practice 21 

Pneumo-Hydro-Thorax— Case of • ^ 

Pistol Shot Wound Through Liver and Lung — Recovery — Case of 40,3 

Quackery ^^^^"' ^'^'^ 

Remarks on Abscesses of the Perinseum and Ischio-Rectal Region 13 

Rupturing Membranes During Labor 24» 

Rheumatism— Electricity for 51 

Scarletina— Acute Nephritis following ■■ 20- 

Scarlet Fever — Hog Lard the sine qua non in 423 

Screw-Fly and its Ravages 391 

Sexual Neurosis— Some Forms of 320' 

Stomach Pumps in Some of the Convulsions of Childhood 145 

Stramonium 60 

Successful Removal of an Ovarian Tumor 1"5 

Sulphate of Zinc 59 

Typho-Malalial Fever — Cause, Prevention and Cure HI 

Ulcers— Electricity for 10* 

Ulcer — Chronic Gastric 386 

Venesection as a Therapeutic Agent 354 

Weaning the Child Cured the Consumption 23 

Weeping Sinew — Electricity for 5 

What is vital Force and What Relation does it Hold to Death and Disease. 279 

NOTES FROM PRIVATE PRACTICE. 

Greasing with Fat Bacon for Scarlatina 475' 

Ischio-Rectal Abscess 477 

Record of 200 Consecutive Obstetrical Cases 478 

Ustilago Maidis 476 

CORRESPONDENCE. 

A Quick Case 246- 

A Thought with Reference to Fermoral Fractures 404 

Card-Index — Continued , 479 

Delivery of Foetus enclosed in Amniotic sac 225 

Good Effects of Ergot 324 

History of a Case — What was it '? 115 

How to Collect Bills 308 

New York Letter 483 

Protection Against " Dead Beats " 158 

Race Adulteration 202 

Severe Injury with Recovery 487 

The Screw Worm 325- 

Typho-Malarial Fever 156- 

BOOK NOTICES. 

Asthma 247 

Change of Life in Health and Disease 204 

Diseases of the Rectum 247 

Diseases of the Rectum and Anus 205 

Diseases of Women 490 

Electricity in Medicine and Surgery 364 

Essentials of Vaccination 248 

Index Rerum. 284 



Table of Contents. V 

BOOK NOTICE a— Continued, 

Page- 

Index of the Practice of Medicine 489 

Legal Medicine — 2 Vols 364 

Manual of Gynecology — 2 Vols 426 

Materia Medica and Therapeutics — Inorganic Substances 133 

Materia Medica and Therapeutics 26 

Medical Formulary 248 

Mental Pathology and Therapeutics 205 

New System of Electrical Medication 27 

Nitro-Glycerine in Angina Pectoris 247 

On Slight Ailments '. 285 

Pamphlets and Reprints 28, 134, 249, 364, 429 

Pathology and Treatment of Diseases of the Ovaries 489 

Physicians' Memorandum Books 284, 286 

Practical Medical Anatomy 133 

Physician Himself 134 

Pocket Therapeutics and Dose Book 428 

Reprints, Announcements, etc 159 

Rheumatism, Gout and some Allied Disorders 285 

Treatise on the Continued Fevers 248 

Treatise on the Physiological and Therapeutic Action of the Sulphate of 

Quinine 158 

Transactions of the American Medical Association 1882 , 490 

Transactions of the Arkansas State Medical Society 248 

Transactions of the Illinois State Medical Society 413 

Transactions of the Missouri State Medical Society 428 

Transactions of the Virginia State Medical Society 426 

What to do in Cases of Poisoning 205 

Working Bulletins 134 

SOCIETY TRANSACTIONS. 

American Medical Association 28, 117, 160 

Brainard District Medical Society 86 

Central Illinois Medical Society 89 

De Witt County Medical Society 29, 492 

Ethical Resolutions of the St. Louis Medical Society 29 

Illinois State Medical Society 87 

Peoria City Medical Society ,29, 85 

PERISCOPE. 

Abdominal Tumors — Ditferential Diagnosis of 258 

Abuses of the Jacket in Spinal Diseases 85 

Abscess of the Liver — Treatment of. . . 132 

Abortion — Treatment of the Placenta after 209 

Action of Iron — Study of 375 

Acute Pneumonia — Treatment of 36 

Aconite in Acute Dysentery 133 

Adhesive Plaster in Umbilical Hernia 21T 

Administration of Belladonna to Children 213 

Advice to Young Doctors 211 

Alcoholism Chronic— Its Pathological Aspects 368 

Alopecia — Areata 434 

Alum Plug for Uterine Hemorrhage 34 

Albumen in the Urine — New Test for 335 

Albuminuria — Basham's Mixture for 403 

Amenorrhoea — Treatment by Permanganate of Potash 442 

American vs. European Profession 451 

Amy 1 Nitrite for Ague 3& 

Anti-pyretic Medicines — Actions and Uses 336 

Antiseptics in Phthisis 449 

Anti-Lislerism 254 

Arsenical Treatment of Chorea 126 

Arsenical Poisoning — Dialys^d Iron in 164 

Arteries — Torsion of 216 

Basham's Mixture for Albuminuria 403- 



■yi The Peoria Medical Monthly. 

PERISCOPE— Gontinued. 

Page. 

Belladonna— Administration to Children 213 

Bismuth in Dyspepsia of Children 440 

Boracic Acid— Clinical Remarks on 300 

Boracic Acid for Granular Lids 257 

Brief Treatise on Therapeutics 405, 430 

Brunelli Process of Embalming 128 

Cannabis Indica in Checking Epistaxis 434 

Carbolic Spray after Tracheotomy 201 

Carbuncles — Carbolic Injections for 132 

Catheterism — Dangers of 129 

Cerebro-Spinal Meningitis— Treatment of 2f)2 

Chloral Enemata in Vomiting of Pregnancy 100 

Choice of Drainage Tubes 260 

Cholera and Filth in Calcutta 379 

Cholera Pills 177 

Chorea — Arsenical Treatment of 126 

Chronic Malarial Haematuria 301 

Chronic Alcoholism — Pathological Aspects 368 

Chrysophanic Acid in Treatment of Psoriasis 366 

Cicatrices — Treatment of 177 

Cinchona — Some Peculiar Effects of 166 

Clinical Remarks on Boracic Acid 300 

Codia in Dysmenorrlicea, etc 30 

Counter Irritation 327 

Convulsions — Infantile 175, 334 

Constipation — Rectal 370 

Cronpons and Diphtheritic Ophthalmia 89 

Cystitis 452 

Deafness — Wisdom Teeth and 452 

Differential Diagnosis of Abdominal Tumors 258 

Dermatology — Recent Progress in 434 

Dentistry — Mercury used in 175 

Delivery of the Placenta 295 

Dialysed Iron 448 

Dialysed Iron in Arsenical Poisoning 164 

Differential Staining of Neucleated Blood Corpuscles 168 

Diphtjieritic Conjunctivitis — Sulphate of Quinine 176 

Diabetes — Puerperal 412 

Drainage Tubes— Choice of 260 

Dyspepsia of Children — Bismuth in 440 

Dysmenorrhtea — Mercury in Membranous 263 

Dysmenorrhcea — Codia in 30 

Dysentery — Aconite in Acute 133 

Earache 299 

Empyema — Treatment of 333 

Embalming— Brunnelli Process of 128 

Epithelioma — Chlorate of Potassium in 173 

Epithelial Cancer and Kindred Ulcers— Curability of 286 

Epithelial Cancer 434 

Epilepsy— Treatment of 33 

Epistaxis— Cannabis Indica in Checking 434 

Ergot in Obstetrics— The Proper use of 437 

Ergot for Spermatorrha^a 130 

Eserine — Traumatic Tetanus Treated with 218 

Excessive Sweating of the Feet 218 

Extension in Sciatica 450 

Foreign Bodies in the Air Passages 174 

Fractured Patella 172 

Glonoine in Cardiac Disease 177 

Gout— Salicylate of Soda as a Local Application 297 

Granular Lids— Boracic Acid for 257 

Hahnemann— Whence Originated the Doctrines of 214 

Haematuria— Chronic Malarial 301 



Table of Contents. vii 

PERISCOPE— Contin ued. 

Page. 

Headache — Codia in Malarial 30 

Headache of Adolescents 377 

Hernia — Some Points in the Reduction of 372 

Hernia — Adhesive Plaster in Umbilical 217 

Hip-Joint Disease — Best Cure for 371 

How to make a Poultice 330 

Hot water in Surgical Practice 250 

Hour Glass Contractions of the Uterus Treated with Nitrite of Amyl 34 

Improved Pharmacy 206 

Infantile Convulsions 175, 334 

Inhalations in Phthisis 261 

Iodoform in Phthisis 207 

Iodoform Dressings in Vienna 208 

Iodoform Poisoning 119 

Iodoform in Purulent Conjunctivitis 257 

Iron — Dialysed 448 

Iron — Study of the Action of , 375 

Iron with 5lercury in Syphilis 131 

Keith and Listerism 127 

Liver — Treatment of Abscess of ." 132 

Lesions of the Teeth in Locomotor Ataxy 340 

Lister's Antiseptic Dressing — Modification of 31 

Locomotor Ataxy — Lesions of the Teeth on 340 

Lumbo-Colotomy in the New Born for Imperforate Rectum 121 

Mammary Gland — Relation between Tumors of 92 

Mastitis Puerperal — Treated by Iodide of Lead Ointment 441 

Membranous Dysmenorrhea — Mercury in 263 

Metritis— Blood-letting in 173 

Mercurj' T'sed in Dentistry 175 

Miscarriage — Definition of 261 

Modification of Lister's Antiseptic Dressing 31 

Nasal Catarrh — Quinine for 256 

Nerve Stretching — Ureter Stretching 217 

Neuralgia 177 

Note on Excessive Sweating of the Feet 218 

Obstinate Vomiting — Treatment of 332 

Ophthalmia — Croupous and Diphtheritic 89 

Ophthalmia Neonatorum 89 

Ophthalmic Aphorisms 208 

Opium Habits — Avena Sativa 263 

Ovarian Dermoid Cysts 129 

Phj'sician and Novelist 162 

Placenta — Treatment of after Abortion 209 

Placenta — Delivery of 295 

Pneumonia in Children 439 

Pneumonia — Treatment of Acute 36 

Post Partum Examination 259 

Poultice — How to make a 330 

Prolific Family 340 

Pruritus Ani 434 

Puerperal Diabetes ' ' . * \ \\ 412 

Puerperal Mastitis Treated with Iodide of Lead Ointment 441 

Pulsatilla in Inflammation of the Testis 252 

Purulent Conjunctivitis— Iodoform 257 

CJuinine as an Oxytocic I43 

Quinine in Diphtheritic Conjunctivitis 176 

Quinine— To Hasten the EflTects of .188 

Relation of Meteorological Phenomena to Man— Some of the 338 

Resorption in the Stomach 339 

Removal of the Entire Uterus for Cancer of the Cenix Uteri. ' ' • • ' . . . . .... 122 

Rhus Poisoning 434 

Salicylic Acid as a Dry Surgical Dressing 36 

Scared to Death " 45O 



viii The Peoria Medical Monthly. 

PERISCOPE— Contin ued. 

Page. 

Sciatica— Simulated ~56 

Sciatica— Extension 450 

Scarlet Fever— Sulphate of Zinc as a Specific in 447 

Septic Infection of the Male H^ 

Skin Grafting— Our Present Knowledge of 91 

Sleeplessness — Codia in 30 

Social Position of the Doctor in England 1'''4 

Some Peculiar Effects of Cinchona 166 

Spermatorrhoea .• 1^9 

Spinal Disease — Abuse of the Jacket in 35 

Sulphide of Calcium as an Anti-Suppurative 128 

Susceptibility of the Uterus — Dangers due to 131 

Summer Coruplaints of Infants l"^ 

Surgery of the Arteries 163 

Surgical Expedients in Emergencies 169 

Syphilitic Infection of the Finger by Medical Men 218 

Syphilis — Iron with ^lercury 131 

Syphilitic Infection, with Iritis from an Oral Chancre 123 

Tape Worm — Treatment of 328 

Telephonic Trouble 216 

Testis — Pulsatilla in Inflammation of 252 

To be Copied into the Practitioner's Note Book 216 

Therapeutics — Brief Treatise on 405, 430 

Tomato as a Dietary 125 

Tonsillitis— Salicylate of Soda in 297 

Torsion of Arteries 216 

Tracheotomy — Carbolic Spray after 201 

Traumatic Tetanus Successfully Treated by Sulphate of Eserine 218 

Tubercle Bacillus and Phthisis 445 

Uterine Hemorrhage — New Method of Treating 293 

Uteri — Epithelioma of Cervix " 100 

Uterine Hemorrhage — Alum Plug in 34 

Vertebrae — Gunshot Wounds of 261 

Viburnum Prunifolium 291 

Vomiting of Pregnancj^ — Enemata of Chloral for 100 

Warts and Corns 434 

Whence Originated the Doctrines of Hahnemann '? 214 

Wisdom Teeth and Deafness 452 

THERAPEUTIC NOTES. 

Abortions — To Prevent 341 

Acute Articular Rheumatism .' 341 

Anti-Pyretic 341 

Antiseptic Stimulant in Typhoid 37 

Atphous Sore Mouth in Infants 341 

Atphous Sore Mouth of Infants 93 

Atphous Vulvitis 93 

Asthma 135 

Blind Piles 93 

Catarrh and Irritability of the Bladder 37 

Camphorited Chloro Tannate of Iodine 219 

Chills 453 

Chordee 135 

Chronic Bronchitis 135 

Chronic Intermittents 453 

Chafe 93 

Constipation 135 

Correct the Order of Lochia after Child Birth 453 

Constipation 93 

Cystitis ." \^',\\ 135 

Cystitis '. "]".] 93 

Depilatory Pomade 93 



Table of Contents. ix 

PERISCOPE— Continued. 

Page. 

DiaiThoea of Phthisis 93 

Diaphoretic in Severe Catarrh with Sore Throat 37 

DysDienorrhcea 135 

Dyspepsia 135 

Dyspepsi-i with Acid Eructations and Debilitj' 219 

Dyspna^a of Phthisis and Emphysema 219 

Eczema of the Hands 93 

Enlarged Glands 93 

Erj'sipelas 3T 

External Hemorhoids 135 

Expectorant Mixtures in Bronchitis 341 

Facial Keuralgia 93 

Gastrodynia 37 

Gelsemium in Rhus Poisoning 219 

Hair Wash 453 

Haemostatic Pills , 37 

Heart Burn and Acid Eructations ~19 

Inflamed Conjunctiva 37 

Injection for Sciatica ; 219 

Incontinence of Urine -^19 

Iodine Caustic 37 

Iodine Paint for Chronic Pains 37 

Iodoform in Ulcers 219 

Leucorrhcea 37 

Membranous Dysmenorrhcea ^^^ 

Mistura Apii Composita 37 

Nasal Catarrh 93 

Neuralgia of the Stomacli!!!"!!!!!. !!!!!!!!!! 341 

Neuralgia— Facial 93 

Nervine and Anti-Spasmodic |fl 

Nervous Exhaustion— Tonic for 341 

Nocturnal Incontinence of Urine 1°'^ 

Nocturnal Incontinence of Urine in Children 37 

Pepsin in Diphtheria 135 

Phagendenic Ulcers 219 

Purgative Liniment 93 

Purpura ^^^ 

Quinidia for Intermittents 13"^ 

Quinine — To Disguise Taste of 4.j3 

Ring Worm 135 

Ring Worm 37 

Rheumatism— Acute Articular 341 

Rhus Poisoning — Gelsemium in 219 

Spermatorrha^a 341 

Scald Head 341 

Sciatica — Injection for -19 

Tasteless Quinine 453 

Tertiary Syphilis 93 

To Disguise the Taste of Quinine 453 

Tonic in Nervous Exhaustion 341 

Toothache Paste 453 

Typhoid — Antiseptic Stimulant in 37 

Uterine Displacements 37 

Vaginitis 453 

Vegetable Liver Pills 341 

Whooping Cough «, 453 

EDITORIAIi DEPART3IENT. 

A Word of Explanation 9i 

A J!^ew Medical College in San Francisco 342 

A Question in Ethics 342 

A Deadly Toy 1'^ 



X The Peoria Medical Monthly. 

EDITORIAL DEPARTME ST— Continued. 

Page. 

An Error Corrected 40 

An Extra Large Number 100 

An Apology 267 

Award of Prizes -. 267 

Bellevue Medical College of Massachusetts 343 

Bound Volumes 45 

Burial Permits 179 

Certificates Issued bv the State Board of Health during August, 1882 226 

Chicago Medical College 99 

Coming Meetina: of the Illinois State Medical Society 492 

Death of Dr. W. H. Brown 491 

DeAVitt County Medical Society 492 

For Sale— Practice 307 

Grundy Co. Medical Society 226 

Hints on Practice 264 

Home Health 491 

Important Announcement "...."..'.'.'..........'..'.!'..]!!.'.".".'..'.*!!!!."!.'."]!!".!!!!!!!.!!!!! 417 

Insanity from Drugs 40 

Is there a Tubercle Parasite ? 96 

Married 228 

J^ew Doctors * 186 

Notes and Xews Items ........41, 44 

Notes and Comments 345, 348 

Notes and News Items 139, 143 

Notes and Comments 302, 307 

Notes and Comments 98 

Notes and Comments 180, 186 

Notes and Comments .380, 384 

Notes and Comments 268 

Notes and Comments 458, 461 

Notes and Comments 419, 422 

Notes and Comments 223, 225 

Obituary— Dr. J. R. Snelling 222 

Offer „ 457 

Old Patients 491 

Physicians' Supply Company 418 

Prof. E. W. Jenks; M. D., L.L.D 230 

Beceipts 4.5,143,187,227,270,348,384,422, 463 

Receipts 492 

Rush College Commencement 457 

Samples of 3Iissouri Quackery 454 

Some Things That May Interest You 46, 144, 228, 370, 307, 462 

Testing of Thermometers 225 

The New York Code of Ethics 39 

The White Mountain Excursions 44 

The St. Paul Meeting of the American Medical Association 136 

The Quincy Meeting of the Illinois State Medical Society 94 

The Qumcy School of Medicine 265 

The Fourth Annual Report of the Illinois State Board of Health 414 

The New York Code 416 

To Contributors .........,...,.'..'.. '.. 40 

Transactions of the American Medical AssocYation.'.'.'.. .'.*."! 188 

Volume III 38 



The Peoria 
MEDICAL MONTHLY, 



Vol. III. MAY, 1S82. No. 1. 



©rtginal aiommuuifati0n$. 



Art. I. — Molar Pregnancy — An Anomalons Case. By O. E. Herrick, M. D., 

54 Monroe Street, Grand Rapids, Michigan. 

Several years ago I was consulted by Mrs. D for a 

persistent pain in the head, occasionally attended after 
three or four hours of severe pain, hy paroxysms of frenzy, 
which would continue from two to twelve or fourteen 
hours, when they would again gradually subside. These 
paroxysms were always attended by a feeling of fullness 
about the head. She stated, upon her first visit to mj 
office, that she was pregnant about four months, and that 
her headache dated from about the time of conception; she 
l^elieved that her headache and spasms would kill her if she 
was allowed to go to full time. I thought that perhaps it 
was but a ruse to get me to produce an abortion, and felt 
quite sure that such was the case, when she added that she 
had importuned her usual medical attendant ( a reputable 
physician ) to produce an abortion to relieve her. and he 
had refused, telling her that her headache and paroxysms 
of frenzy were entirely independent of iier pregnancy. 

One thing which made me suspect, however.that the case 
was not a case of ordinary pregnancy, was that she flowed a 
little at each monthly period and her breasts were flaccid, 



2 The Peoria Medical Monthly. 

although she wa:i a woman of full habit, while she had 
leucorrhoea almost continuously. I heard nothing further 
from her until May 2. when I was called in haste to see 
her. I found her suffering from severe pain in the head^ 
fVice flushed, and with symptoms of mania well marked^ 
although there were lucid intervals, but upon the return 
of pain she would again become violent. I gave her 20 
grains of chloral hydrate every two hours, and fluid extract 
of ergot. 15 drops every hour. ( I gave the last to lessen 
the circulation in the brain.) After the third dose of chloral 
she became quiet, and shortly dropped off' into a sleep and 
slept until about midnight quite naturally, when she awoke: 
and although she was still delirious was much more quiet 
than before. She was given another 20 grain dose of chlo- 
ral, and in about twenty minutes again fell asleep and slept 
until morning, at which time I saw her again, and found 
her rational and suffering only slight pain in the head. I 
then made a vaginal examination and found the uterus 
enlarged to about the size it should attain at a Ave months' 
pregnancy; but instead of having the hard feel of the preg- 
nant uterus it had a flabby, s^pongy feel; the os was dilated 
so that it readily admitted the finger, and I found that the 
neck was occupied by something which appeared to the 
finger like a piece of placenta. I introduced a gum-elastic 
catheter into the cavity of the uterus and injected through 
it with a common bulb syringe about eight ounces of warm 
water; also continued the ergot. In about three hours 1 
called again and found her flowing quite liberally and un- 
dergoing pains at regular intervals. After waiting about 
an hour, and after a pain of unusual intensity. I made an 
examination and found laying in the vagina a fleshy, fibrous 
mass, covered externally by a membrane, which might have 
been decidua in a natural condition, while the inner surface 
of the mass was lined by a fine memljrane having the usual 
character of the amnion. After passing the mass her pains 
suddenly stopped and the flowing was very moderate. I 
then left her. with instructions to take the ergot at longer 
intervals, about three hours apart. I called the next morn- 
ing and found she had passed three more, almost exactly 
like the first, about two inches in diameter, and she con- 



Original Communications. 3 

tinned passing them for four days, until she had passed 
eleven of them, the last three of which I removed with the 
wire scoop; during all this time her flowing was quite mod- 
erate and at no time severe. She made a rapid and good 
recovery, and has had no return of head symptoms since. 

It is not an unusual thing for the uterus to be filled with a 
large number of vesicles of irregular shape and size in the 
hydatid form of mole pregnancy. But it is, I believe, an 
unheard of thing for the variety described above to occur 
in such numbers and each one entirely distinct from the 
other. It w^ould seem as though a whole crop of ovules 
had been blighted and that each one had commenced life 
W' ith a distinct and separate placenta. Another interesting 
feature of this case is the neurasthenia. The condition of 
this patient was exactly the opposite from the conditions 
of patients said to be suffering from puerperal mania as de- 
scribed by authors upon that subject. She was a robust 
w^oman, j^lethoric and strong, not w eakened by hemorrhage 
or other abnormal discharges, except, perhaps, leucorrhffia. 
and that had not weakened her. as her circulation w-as un- 
usually strong during all her trouble. Authorities tell us 
that the cause of puerperal mania is anaemia, caused by 
hemorrhage, malignant disease of the uterus, abortion, etc., 
and is a disease which arises from great exhaustion. 

The question I wish to raise is. may it not occur from ex- 
actly the opposite condition: instead of the brain being anee- 
mic and not having enough blood supplied it, may it not have 
too much, as is the case in alcoholism, etc.? I believe both 
these conditions may produce maniacal excitement, and 
that one is as likely to produce it as the other, and hence 
the necessity of recognizing the diflerence of origin before 
commencing treatment. Diseases of the uterus of all kinds 
seem to exert a powerful influence upon the whole nervous 
system, and the brain being the great nerve center is 
especially apt to be more or less influenced by an}^ severe 
or protracted disease of the uterus; it need not necessarily 
be pregnancy, nor need it occur only after a tedious deliv- 
ery; but may, and frequentl}^ does, occur from any long 
standing inflammation or congestion of that organ. I have 
seen it in bad cases of dysmenorrhoea: I have also seen it 



4 The Peoria Medical Monthly. 

as melancholia, in cases of displacements of long standing. 
We frequently observe it among frail married ladies living 
with strong vigorous husbands, occuring from excessive 
coitus. The uterus is kept in a constant state of conges- 
tion and the woman is converted into a maniac, and hates 
the man she should love better than all others, and for no 
other reason than that her l^rain is influenced by her much 
abused uterus. No matter what in each individual case the 
disease may be called, it is simply mania. The fact that 
the woman can no longer control her mind is sufficient evi- 
dence that she is insane. That point once settled in the 
mind of the attending physician, he should always look 
after the state of his patient's uterus. If he finds that she 
has recently passed through childbirth and is suffering from 
puerperal fever, he should treat her for that disease. If his 
patient is in labor and is attacked with violent pain, heat 
and throbbing of the head, which is greatly increased by 
her uterine pains, the cerel)ral excitement becoming in- 
tense, followed by furious delirium or convulsions, then he 
should deliver at once and treat her for ordinary convul- 
sions, which is but another form of this same class of diffi- 
culties. If the patient has dj^smenorrhoea and loses control 
of her mind, call it hj^steria if you will, but it is uterine 
mania, just the same. Do not leave her to get well the best 
she may, but treat her dysmenorrhoea and you will un- 
doubtedly cure her mental difficulty. A patient with dis- 
placed uterus should have it replaced and retained there 
after some common sense method. If the woman's hus- 
band is the cause of her trouble, either send him or her on 
a visit and her peculiar form of insanity will probably 
vanish. In short, treat each individual case and ignore the 
classes. 



Aet. I[.— Cliiiual Contributions to Klectiical Tlierapentiis. Paper No. VI. 
By Komaine J. Curtiss, M. D., Joliet, IlL 

ELECTROLYSIS. 

The meaning of electrolysis is decomposition of chem- 
ical and morphological structure by the galvanic current. 
It has been verified by experiment that no animal tissue 
can resist the disintegrating effect of the negative pole, and 



Original Communications. 5 

that the rapidity of the disintegration of tissue is in direct 
ratio to the amount of electric force and to the stability of 
particular tissues. There is no form of morbid growth, 
whether bone, cartilage, cellular or fibrous tissue that will 
not yield to the galvanic current. The importance of this 
•demonstrated fact in relation to tumors, indurations, etc., 
need not be enlarged upon. The question of galvanism or 
the knife in the surgerv of morbid growth is simply one of 
•convenience, taste or prejudice. 

TUMOES — WEEPING SINEW. 

Case 1. — Miss contracted a ''weeping sinew" on 

the tendon of third extension of thumb from, probably, no 
severer exercise than piano playing. She had worn lead 
foil, made into a compress, for some time, and, in fact, was 
wearing this doubtful ornament when she consulted me. 
A surgeon's needle was inserted into the tumor, to which 
was attached the negative pole, the positive pole — a wet 
sponge she held in her hand. The force of the current was 
gradually developed to 60 cells, with diminished intensity, 
and continued for five minutes. The tumor swelled 
rapidly by evolution of hydrogen, somewhat to the conster- 
nation of the young lady who was watching proceedings 
with very intense interest. Absorption of the decomposed 
products was complete three days afterwards, when I met 
her on the street and she remarked, "" my weeping sinew 
has gone where the woodbine twineth." I am convinced 
that the galvanic treatment of this sort of tumor is an ad- 
vance on the old bibliographical method, and that books 
€an be put to a better use, especially modern works relating 
to electricity. 

CYSTIC TUMORS. 

Case 2. — Mr. noticed the growth of a tumor situ- 
ated below the right scapula and took notes of its develop- 
ment with not a little apprehension. When I saw the 
growth it was of considerable size — about eight inches in 
its longest circumference. He refused cutting surgery, but 
consented to the use of the galvanic needle. Three needles, 
the negative pole, were inserted into the tumor. The 
needles were not insulated. The positive pole was applied 



6 The Peoria Medical Monthly. 

near the tumor to the surface, and 60 cells were used for 
ten minutes. A large quantity of the coagulated contents 
escaped alongside the needles. Patient was requested ta 
call again for another electrol3'sis in three days, which he 
did according to appointment, but owing to circumstances 
over which he had no control he neglected to bring his 
tumor with him. Electrolysis most effectually destroys 
the secretory function of the lining meml^rane of a cystic 
tumor, and I have never known, in twenty odd such cases 
on which I have practiced electrolysis, any return of the 
cyst. This method is far preferable to the knife, as in 
extirpation all of the cyst membrane must be dissected 
out. 

Case 3. — Mrs. , aged about 30. mother of four chil- 
dren, discovered a tumor in her left breast. She diagnosed 
a cancer and became greatly alarmed, concluding to meet 
death without surgery or caustic. I could not persuade 
her to have the electrolytic needles inserted into the tumor. 
She became persuaded to allow a current of galvanism 
from sponge electrodes to be passed through the tumor. 
This operation was repeated three or four times a week, 
and in three months the tumor had entireh' disappeared. 

ADENOID TUMOR. 

Case 4. — Miss , aged 20. had adenitis (scrofulous) 

of the cervical glands, resulting in development of tumors. 
Two of these growths measured each over six inches in 
longest circumference. They had remained stationaiy for 
several months, while she took cod oil. Shaker s iodo. brom. 
calc. comp., and various other medicines. Electrolysis was 
employed in this case by using from three to five needles 
at each time, attached to the negative pole. The tumors 
gradually disappeared and at the end of three months were 
gone without suppuration. 

Case 5. — Mrs. , aged 40, multipara, had scrofula^ 

resulting in several adenoid tumors. Electrolysis was used 
as before with the result that the glands suppurated or 
broke down into a condition of more stable structure 
morphologically. The treatment was continued in this 
case about two months. In these cases a notable difference 



Original Commuxications. 7 

in results of electrolysis occurred, depending upon whether 
insulated needles were used or not. When insulated 
needles were used and the skin protected no discharge of 
decomposed matter would occur, hut if the common needles 
were used a discharge occurred alongside the needles dur- 
ing the passage of the current and following it. I have 
learned that in tumors as cysts, and in exudations and 
effusions containing albumen, that insulated needles are 
preferable — the coagulated contents being readilj' ab- 
sorbed; but in scrofulous and malignant growths the com- 
mon needles for obvious reasons are preferable. 

EXCEPHALOMA. 

Case 6. — Mr. . aged about 50. discovered a small 

tumor on top of his shoulder, about the middle of the 
length of the clavicle and just above. In six weeks the 
tumor was as large as a pint cup. and was removed by an 
amateur surgeon who called it " one of them wen tumors.*' 
In two months the tumor was as large as ever and I was 
consulted. The patient was discouraged with surgery, and 
I could give him no encouragement from any treatment. 
He was entirely unaware of the gravity of his disease and 
was astounded at the diagnosis of cancer. By way of ex- 
periment I electrolysed the tumor. In this operation two 
needles, not insulated, were inserted near the top of the 
tumor, to which was attached the positive pole, and three 
needles through the base being the negative. The current 
from 80 cells was passed for halt an hour, during which 
time the discharge of half the tumor alongside the needles 
occuiTed. The discharge was of course the product of 
electro-chemical decomposition of the tissue and was a 
creamy colored, semi-fluid substance, frothy by reason of 
contained hydrogen. These electrolytic treatments were 
repeated once a week for several weeks, the electrolytic 
effect being the same each time, and at the end of this- 
time the tumor was smaller than when the treatment was 
begun. Electrolysis I found will destroy an encephaloid 
just about as fast as it grows. The patient, i^oor fellow,. 
became nearly insane over his cancer, visited Chicago and 
sx^ent a day consulting physicians, even visiting the shin- 
ing lights of homoeopathy and the surgeons, who advised 



S The Peoria Medical Monthly. 

him that as electricity appeared to be a benefit to continue 
it. When he returned, however, he was directed by a lay 
apostle of stupidity to a notorious cancer quack, whose pa- 
tient he became. (What a blessing it is to have the assur- 
ance of authority that there are only " four " cancer doc- 
tors left in the state.) The cancer doctor applied an arsenic 
paste, which was followed by violent inflammation and gan- 
grene of the arm. and the patient lived only a few w^eeks. 

Case 7. — W. M , socially a '' bad Qgg^ had a tumor 

situated on his face below the right eye, and close beside 
the alse of the nose. The appearance of the tumor was 
like a finger growing from the face. It was about the di- 
ameter of the ordinary ring finger, and about an inch and 
a half in length. He stated that the growth had occurred 
in about six weeks' time; that he had consulted several 
surgeons who shook their heads at it, and one of them had 
applied nitric acid to the tumor with the effect of "putting 
a head on it.'' I could not believe from evidence that this 
growth was a cyst. I inserted five needles around and 
deeply below^ the base of the growth and one through the 
apex. The current of SO cells, resisted by 6,000 units, was 
gradually turned on and the decomposed mass poured out. 
The patient wore a cinder in the place of the tumor for 
about a week, when it dropped off, disclosing a deep cavity 
filling with granulations. After six months there is no 
further return of the growth. This patient was prejudiced 
against cutting surgery. 

ERECTILE TUMORS. 

(\ise 8. — Mr , aged about 40. had a tumor of his 

right ear which I thought was a polypus and attempted to 
snare it, and later to twist it with forceps. On further in- 
quiry I "learned that the growth had been there several 
years, and that at times it would disappear and at other 
times fill the meatus full and protrude from it. The nature 
of the thing finally dawned o^i my mind and I inserted a 
needle deeply into the growth, attached the negative pole 
and placed the positive behind the ear. The patient could 
endure but 20 cells, the current from which was used about 
fifteen minutes when the tumor disappeared and never re- 
turned. 



Original Communications. ^ 

Case 9. — Mrs. — — , aged about 36 3' ears, had a tumor 
similar to the previous case. I treated it the same way- 
three times in three days, without effect, greatly to my sur- 
prise. After the last ineffectual electrolytic treatment I 
injected the tumor with ergot. The patient did not return 
and I heard afterwards that the tumor disappeared. A day 
or so after this failure I learned the cause of it. I had used 
the battery with which this operation was made almost 
daily for five years, and yet when 1 treated this patient I 
mistook the negative and positive binding posts, using the 
positive pole instead of the negative. Some mysterious 
commutator had reversed my conception of the compass 
relating to the accessories of the battery and held me there 
for three days, when the mental current was again reversed. 
Since that time, mindful of my own failings, I have marked 
the binding posts. 

FIBROID TUMORS. 

Case 10. — Mrs. , aged 38 years, sterile, and married 

about 16 years. This lady is portly, weight about 200 
pounds, has always been generally healthy until about five 
years ago when she began to have pelvic symptoms — she 
had pain and her flow^ increased during menstruation. In 
time she had leucorrhoea. the character of the discharge 
being irritating and exciting pruritus. About a year ago 
she decided to have her source of troubles inspected. To 
my surprise on making digital examination I found the cer- 
vix enlarged, the tactile sensation being like that afforded 
by the foetal head when felt through the cervical walls. 
The OS was rigidly closed. By bimanual examination the 
uterus was found to be proportionately enlarged. No foetal 
bruit could be heard, nor were there objective signs of 
pregnancy; though when the subject was mentioned patient 
declared she could feel '"motion." Remembering some- 
body's adage that when a woman has enlargement of the 
uterus and is living with her husband the chances are she 
is pregnant, I waited three months and made another exam- 
ination with similar results. During this time patient 
menstruated regularly. I now introduced a sound and 
found depth of uterus to be seven and a half inches. Some 



10 The Peoria Medical Monthly. 

further time was spent in examinations, when I deter- 
mined the disease to be a submucous fibroid. Squibb's 
ergot was prescribed and the galvanic current passed 
through the tumor, the negative applied to the cervix and 
positive to the abdomen. Alter three months of this treat- 
ment, the electricity being applied three times a week, and 
ergot being taken in doses of twentj- drops three times a 
day, the size of the uterus was decreased by measure with 
the sound to four inches. The amount of menstrual dis- 
charge was notably lessened. The treatment of this patient 
is continued with the expectation of a final cure. 

Case 11. — Mrs. , aged 30. primapara, has com- 
plained of uterine symptoms since birth of her child, which 
at the time I saw her, was twelve years old. She had 
leucorrhoea, excessive flow during menstruation, and the 
subjective pains and distress of uterine disease. By digital 
manipulation I diagnosed retroversion and applied a pessary 
after repositing the uterus as I supposed. She was not re- 
lieved, and I found by introduction of the sound that I was 
in error al^out the retroversion and that the patient had a 
small submucous fibroid, situated in posterior wall of the 
uterus. The tumor occupied the cavity of the sacrum, and 
the sound when introduced took the normal direction. The 
treatment of this case was by ergot and gah'anism, was 
continued for six months and was successful. 

ULCERS. 

Cam 12.— Mr. , aged 60 years, a feeble "neuras- 
thenic " subject, had an ulcer on his leg — anterior surface, 
which had annoyed him several years. He had no varicose 
veins, or history of venereal disease. He had been treated 
by black wash, iodoform, adhesive straps, and rubber band- 
age, without success. A piece of thin silver was cut to fit 
the ulcer, a silver wire about three inches long was at- 
tached to the plate, and extending upwards was attached 
to a zinc plate which was wrapped in chamois skin. This 
machine was bandaged to the leg and left in place for 36 
hours, the chamois skin being kept wet with vinegar. On re- 
moval the ulcer was found filled with granulations, and 
was soon entirely healed. 



Original Communications. 11 

Ca.se 13. — Mrs. , aged about 35 years, had an ulcer 

•or ulcers situated on her back between and extending partly 
over both scapulae, which, she stated, had existed for 15 
years. They would occasionally partly heal up, but were 
generally scabbed over. She had never felt much itching 
or pain, except just before a fresh outbreak of the disease, 
which she could always foretell by local sensations. The 
scabs were thick, set into the skin at their edges and ad- 
herent, and were decidedly queer in color. The floor of 
the ulcer was pale and contained pus. The different por- 
tions of the ulcer varied much in depth. The odor was 
most intense and disagreeable. There was no mistaking 
the character of the lesion, which, however, was incom- 
patible with the patient's social character and position, or 
would be, were it not well known that specific danger may 
lurk even in the " holy kiss." The patient was ordered io- 
dide of potassium and mercury, which she could not take 
in any dose on account of nasal irritation. She would 
sneeze several hours after taking three grains of the iodide. 
To experiment I tried the effect of galvanism, applying the 
negative pole — a wet sponge to the floor of the ulcer, the 
positive over the healthy skin. Patient could only endure 
the current from ten cells — with greatly lessened tension. 
Applications weve made in this manner for several weeks, 
every other day, with no beneficial effect, when without 
any expectation of accomplishing good I applied the posi- 
tive pole to the ulcer. The effect was magical, for after 
six applications of the current in this manner the ulcer 
entirely healed. The patient in a short time gained thirty 
or forty pounds in weight, and was a subject of much won- 
dering speculation among her friends. I will mention here 
that I have used galvanism in perhaps fifty cases of buboes 
always with satisfactory effect. Patients are often worried 
and physicians perplexed by buboes which remain large, 
hard and permanent, will neither disappear nor suppurate. 
The negative pole makes very short work of this sort of 
bubo. I have never seen one withstand more than six ap- 
plications without breaking down. In indolent suppurat- 
ing buboes I prefer the positive pole of the galvanic 
current to any other remedy known to me. 



12 The Peoria Medical Monthly. 

Art. III.— Remarks on Abscesses of the Periiiaeuin and Ischio-Rectal Region. 

By Robert Roskoten, M. D., Peoria. Read before the Dickinson C'lub. 

The protected location of the perinaeum explains the 
infrequent occurrence of traumatic injuries of this region, 
but its intricate structure and liability to become involved 
in affections of adjacent organs make its close study im- 
perative. Topographically speaking the perinaeum in the 
male comprises all the structures intervening l^etween the 
pubic arch in front, the rami of the pubes and ischia later- 
ally and a line draw^n transversally between the tuberosi- 
ties of the ischia in front of the arms, while the ischio- 
rectal region extends backwards as far as the tip of the 
coccyx and contains the termination of the rectum. I will 
refrain from describing all the minutiae of the anatomical 
structure which, in our student days, were so indelibly im- 
pressed on our memories, but would only recall your atten- 
tion to the arrangement of the fasciae, the knowledge of 
which will enable us to understand some otherwise ob- 
scure phenomena connected with some affections of this 
region. 

The superficial fascia is divisible into two layers, of 
which the external is thick, contains a large quantity of 
fat and is continuous with the corresponding fascia invest- 
ing the thigh, nates and abdominal walls, and with the 
areolar tissue around the anus. The deep layer of the 
suiDcrficial fascia which is designated as the '' superficial 
perinaeal fascia" is of an aponeurotic character, thin and 
strong, binding down the muscles of the root of the penis, 
continuous with the dartos of the scrotum, attached later- 
ally to the rami of the pubes and ischia as far as the tul^era 
ischii, while posteriorly it curves behind the transversus 
perinaei muscles and becomes attached to the margin of 
the deep perinaeal fascia. After removing this fascia three 
pairs of muscles are exposed to view, forming the boun- 
daries of two triangles; the accelerator urinae uniting with 
its fellow of the opposite side in a median raphe to encircle 
the bulb and part of the urethra anterior to it — the erec- 
tor penis on each side and the transversus perinaei pos- 
teriorly. The floor of the two triangles thus bounded is 
formed by the deep perinaeal fascia; it contains the super- 



Original Communications. 13 

ficial perinaeal vessels and nerves and the transverse peri- 
nseal vessels resting on the transverse perinaeal muscles. 
The deep perinseal fascia is triangular in form, attached by 
its apex to the subpubic ligament and the lower margin of 
the symphysis pubis, laterally to the pubic and ischiadic 
rami internal to the attachment of the superficial perinseal 
fascia, while inferiorly (posteriorly) it curls forwards to 
become continuous with the deep layer of the superficial 
fascia. It consists of two layers which are united below, 
but separated above. It is perforated by the urethra an 
inch below the symphysis; above this orifice by the dorsal 
vein of the penis and on each side by the internal pubic 
artery and nerve. The anterior layer is continued upon 
the bulb of the urethra, while the posterior layer spreads 
out over the prostate gland. Between these layers are 
found the membranous portion of the urethra, the ure- 
thral muscles, Cowper's glands and numerous vessels and 
nerres. 

Abscesses in the proximity of and more or less inti- 
mately connected with the rectum are lial)le to occur in 
both sexes, while those resulting from diseases of the 
urinary passages are almost exclusively limited to the male 
sex. 

Perinteal abscesses are either primary or secondary. 
The former are sometimes the result of a contusion suffered 
while riding on horseback, of a ^11 upon a projecting body, 
of a kick, or of the pressure by the head of the child dur- 
ing labor, even without rupture of the perin^eum, or they 
originate from constitutional diseases such as phlegmonous 
eiysipelas. 

Secondary abscesses are connected with the patho- 
logical processes of adjacent parts. Diseases of the rectum 
frequently give rise to abscesses in the surrounding tissues, 
while those of the latter in almost every instance termi- 
nate in fistula of the former. But in the great majority of 
cases perineeal abscesses are developed from diseases of the 
urinary passages. Among the most fruitful causes are in- 
filtration of urine in ruiDture of the urethra consequent on 
stricture, in perforation from other causes, for example: 
False passages made by the unskilful use of instruments. 



14 The Peoria Medical Monthly. 

As the follicles are arranged iu sucli a manner that their 
orifices have a direction forwards, it is obvious that in 
urethritis, when their mouths are widely open, affording a 
resistance supposed to be due to a slight stricture only, a 
catheter can easily pass through them, into and through 
their dilated cavities and thus deceive the introducer as to 
the course the instrument has taken. The softened foll- 
icles, surrounded by loose tissue, readily give way and thus 
the mischief is done. Inflammation of one or both Cow- 
per s glands, with suppuration following, may also result in 
an abscess of the peringeum. A periprostatic abscess 
usually opens into the rectum, but in some instances the 
matter finds its exit through the perina^um. Small ab- 
scesses around the anus are frequently noticed in the 
vicinity of hemorrhoids. They are of little importance 
and will heal spontaneously with cleanliness and under 
the use of mild applications. Ordinaiy boils or furuncles 
may occur in this locality, give rise to great distress and 
are to be treated on general principles. 

With a view to avoid suppuration which frequently 
follow\s contusions from horseback riding, an antiphlogistic 
treatment should be initiated at once: leeches and the ap- 
plication of subacetate of lead, properly diluted, will 
answer this purpose. 

Erysipelatous phlegmon exhibits a hard and painful 
swelling, very slow in suppurating. Though sedative poul- 
tices containing narcotics. /. /., poppy-head, hyoscyamus, 
etc.. will allay the suftering, yet it is better to relieve the 
tension early, by a large and deep incision, to evacuate any 
pus or mortified tissue that may be present, and to acceler- 
ate the unavoidable suppuration — the same reasons which 
prompt us to make an early crucial incision in a carbuncle. 
Supp*uration around the rectum occasionally reaches such 
an extent that the denuded gut hangs free iu the cavity of 
the abscess, bathed in pus. To obviate the imminent dan- 
ger of perforation of the rectum, our aim should be to se- 
cure early firm granulations by giving free exit to the pus, 
by keeping the cavity open by lint or wax-tents, and by 
stimulating applications in the shape of injections or sitz 
baths, etc. 



Original Communications. 15 

If a fistula has been established it require* the usual 
operation. It should be remembered that suppuration in 
these parts have a decidedly depressing effect on the whole 
system and that, therefore, a course of tonic treatment is 
demanded. As already stated, infiltration of urine after 
perforation of the urethra, is the most frequent cause of 
perinseal abscesses. It is evident that the portion of the 
canal immediately behind the obstruction becomes greatly 
distended and while the membranous part affords the least 
resistance, it is the first to give way before the pressure. 
In the beginning only a slight fissure is formed, through 
which a small quantity of urine oozes out. The escaped 
urine immediately sets up a violent inflammation, rapidly 
followed by mortification, by which the rent is enlarged. 
The contraction of the hypertrophied bladder now forces 
larger quantities of putrid and decomposing urine through 
the opening into the surrounding areolar tissue, the fluid 
making its way forwards through the anterior layer of the 
triangular ligament beneath the deep layer of the super- 
ficial fascia, ascending upon the external organs of genera- 
tion, the groin and anterior wall of the abdomen. The 
extravasated urine can neither gravitate backwards towards 
the rectum, nor laterally into the thighs, being confined 
by the attachments of the superficial perina?al fascia. In 
rare instances the latter gives way and infiltration of the 
ischio-rectal region and the thighs, with extensive mortifi- 
cation, is the result, whereby the rectum may become de- 
nuded to -the extent of several inches. Unhealthy suppu- 
ration is excited and we have a large irregular abscess 
containing a mixture of acrid, decomposed urine, fetid pus 
and sphacelated areolar tissue. When the escape occurs 
deeply between the two layers of the triangular ligament, 
l^atient feels relieved for a moment, but soon complains of 
a burning, throbbing pain in the perinaeum. Fluctuation 
as well as a tumor can not as yet be detected, the urine 
being compressed or bound down by the superficial peri- 
nseal fascia. Gradually, how^ever, it makes its way forward 
into the scrotum, which l^ecomes greatly distended and 
soon shows all the signs of violent infiammation, followed 
by gangrene of the skin and underlying tissues, by which 



16 . The Peoria Medical Monthly. 

the testicles even may be laid bare. If the urethra is rup- 
tured immediatel}^ in front ot the anterior layer of the 
deep perinaeal fascia, swelling and the signs of inflamma- 
tion rapidly become manifest, while the course the urine 
follows is the same as in the former case. 

There is still another form of abscess which begins 
like the former, but differs from it in its subsequent his- 
tory. In this form, from any cause, a few drops of urine 
escape, around which a capsule of plastic lymph is formed. 
Suppuration soon supervenes and an abscess of compara- 
tively small size is produced, which ultimately points in 
the perinseum. It communicates with the urethra and, 
therefore, becomes a urinary fistula. As soon as such an 
abscess is diagnosed it should be opened freely, lest the 
barrier be broken down and extravasation of urine with 
its more dangerous results occur. 

The same applies to all abscesses connected with the 
urinary passages. The opening into the urethra is liest 
made upon a grooved sound. A soft catheter should next 
be introduced and retained in situ to keep the bladder 
empty. A cardinal indication is to secure the evacuation 
of the irritating fluid, wherever it is accessible. Of course 
the discussion of urethral stricture in all its aspects and its 
treatment lies beyond the object of this paper. 

In conclusion, I may be permitted to append the his- 
tory of a singular case of perinatal abscess, or rather, 
fistula. It is well known that abscesses of the greater 
labia in newl}^ married women are not uncommon. 
Prompted by motives of undue modesty they rarely consult 
a physician early. The abscess opens spontaneously and 
discharges a quantity of sanious pus, but rarely in a posi- 
tion, nor with an opening large enough to secure a com- 
plete evacuation; consequently the pus burrows back to 
the posterior commissure, forming a fistula. But in my 
patient the pus, singularly enough, had gravitated towards 
the anus, forming a considerable tumor; when pressed upon 
a large quantity of matter welled out from the opening in 
the labium. I would be glad to have this uncommon di- 
rection of the burrowing accounted for. It is scarcel}" 
necessary to say that the whole track had to be laid open, 
before recovery could be started. 



Original Communications. 17 

Akt. IV. — Necessity for Change in Medical Legislation. Paper read before the 
Vermilion County ^ledical Society. By R. B. Ray, M. D., Fairmount, 111. 

Mr. President and Members of the Society : 

Having been notified by letter from our worthy secre- 
tary, dated March 24. that the committee of arrangements 
would expect me to present some thoughts for the consid- 
eration of the society, touching a medico-legal question 
(which, allow me to say. has hitherto been en- 
tirely neglected by this society and, so far as I 
know, by the medical organizations of this state generally)^ 

I will, therefore, ask your indulgence for a very short 
time, that I may present for your consideration what seems 
to me to be some existing evils which should be removed 
so far as possible. But first, let me preface what I wish to 
say, by mentioning some of the demands made upon us. 
It would be superfluous in me at this time to more than 
touch upon the arduous labor performed by the phy.sician. 
You are all, unless I except our junior members, sufiiciently 
informed on this subject. Public sentiment and past usage 
demand of us as a profession that we contribute freely to 
all charities, to all benevolent institutions; that we treat 
largely the poor gratuitously, furnishing medicine in most 
cases, which to us is cash, and boarding ourselves. This 
demand, I need not say. does not exist to any considerable 
extent in any avocation except that of the physician. As 
a profession we forego largely the enjoyments and pleasures 
of society, by reason of professional engagements; holding 
ourselves in readiness at all hours to answer professional 
calls by day or by night, being expected to administer to- 
rich and to poor alike, not unfrequently giving our best 
energies and talents to a non-paying patient, who often 
pays us off in frequent installments of curses, adding where 
opportunity offers, where he can most injure you privately 
and professionally, that you are an unprincipled quack, etc., 
and in some cases extorting money from you in courts of 
law for pretended malpractice. Health and comfort are as 
sweet to us as they are to others. Ours is a profession of 
exposure, fatigue and danger. We are . called from warm 
beds and comfortable rooms into the bleak, wintry storms, 
subjecting ourselves to interrupted rest and meals while 



18 The Peoria Medical Monthly, 

others are quietly resting at home in security and comfort. 
Not only this, but we are expected, while others flee awa}^, 
to stand in the front ranks, battling against the onward 
deadly march of epidemics thus exposing selves and 
families to their blighting poison. A passive indifference 
on our part, pertaining to pecuniary remuneration, has led 
many to believe that ours is a work of charity only. I am 
selfish enough to think that we, as well as others, should 
be paid tor our labor. Men and women of other avocations 
exact this, and are we less worthy than they, that we should 
be deprived of our fees, or is our labor less? It is doubtless 
true that our yearly income is growing less each year from 
losses by non-paying patients and from contiguous rivals. 
Not only this, our expenses of living have greatly increased, 
wdiile our fees have remained much the same. Other 
branches of business demand almost exclusively cash, while 
ours is one of credit, thus subjecting us to great losses. 
We must go, pay or no pay, or be severely censured by the 
public for refusing, while no thought of censure rests on 
the merchant or druggist who refuses to trust the same 
persons for goods from his store. The men who are un- 
charitable enough to censure us would not. at the same 
time, credit a non-paying customer for a nickel. Can we 
devise remedies that will meet our just demands and give 
us what belongs to us? Promises, feebills and other obli- 
gations have been adopted from time to time, but as often 
have they been violated by the unscrupulous. Then, when 
we remember that we are only a branch of the great whole 
and until entire co-operation be affected no lasting benefit 
can be obtained. To bring members of other schools into 
our societies, or us into theirs, would be an incompatability 
such as could not be hoped for, and by many not desired, 
owing to the many incongruities existing. But in financial 
legislation we could agree, for in this we are mutually in- 
terested. 

Members of this society, legislation has thus far left 
us helpless as a profession, yet exacting much from us. 
What I ask is that existing laws be so modified as to give 
us our hard-earned fees, as it gives the day laborer his with 
no exemption. The constitution of the state demands that 



Original Communications. 19 

we pass liberal exemption laws. If we must have such 
laws let us have them, but not four hundred dollars of per- 
sonal property exempt from execution, and beside this a 
homestead worth one thousand dollars, with a recent con- 
struction such that a man can go out of the state with all 
this, and if he gets into the happy land of Kansas, the debt 
is paid in three years by statute of limitation. By reason 
of these existing laws twenty-live per cent, of our patron- 
age beome legally non-paying. These laws, gentlemen, 
were no doubt intended to protect the honest poor, but 
alas, they reward dishonesty and are an incentive to crime. 
It is the conviction of my mind, that unless our laws are 
changed in this respect, ultimately the better class of phy- 
sicians must give up the field to those less worthy. If a man 
takes my labor and my money I want no law for him to 
stand behind, but let him pay me, and the same if I owe 
him. I want the poor to have the best medical treatment 
the country can afford. I am in favor of, outside of town- 
ships where there are county houses, letting the poor select 
their physician, as they do who pay, and not subject them 
to the services of whoever the supervisors may wish to 
employ through political influences. Let the county pay 
a reasonable compensation, as it does for the unfortunate 
poor who secure merchandise at county expense. Be it 
said in honor of our profession, that the deserving poor 
will find in us as a class, the hand of charity extended to 
them to compare favorably with any other class of our 
fellow citizens. In acts of kindness, benevolence and 
charity no men give more freely and liberally than doctors. 
Since we have a board of health deriving their i^owers from 
the legislature of the state, and since sanitary laws will 
have to be enacted, protecting the people against epidemic 
influences, should we not have a good representation from 
our profession? I do not call to mind a single case from 
our ranks, since the time when our now venerable and hon- 
ored Doctor Fithian represented us in the state senate. 
They have been. chosen entirely from the ranks of other 
pursuits. 

Gentlemen, last but not least, laws should be passed 
providing for the improvement of our highways. The 



20 The Peoria Medical Monthly. 

subject of making good roads and thorough drainage should 
elicit our earnest consideration, both for health and com- 
fort. None should be more interested in this than the 
phj'sician, especially the country doctor who, as you know, 
has to ride through mud and mire from four to six months 
in the year, to see his patients. 

Finally, the increase in foreign population is such that 
to prevent the spread of epidemics, of which we have had 
so sad experience within the last few months, and to pro- 
tect our homes and firesides we need protective laws. 
These w^e cannot fully have without legislation from men 
who understand the demands of our state in this direction. 
If this be obtainable, which I l^elieve it is. let us work to 
this end. This cannot, perhaps, be done in a year, luit the 
foundation can be laid that will give equity, justice and 
protection in the end. 



Art. V. — Acute Nephritis Following Scarletina.— By F. E. Sherman, M. D., 

Chicago, 111. 

Karl F— — , aet. 12, German, nervous temperament, 
recovering from scarletina. was suddenly taken with sup- 
pression of the urine and general dropsy followed. He 
had been attended by an JionunicuJus. who, u^Don the con- 
firmation of the above mentioned symptoms, abandoned 
the case. I was consulted and upon examination found 
the subject in the following condition: Pulse 1)5, tempera- 
ture 103 F.. respiration hurried, anorexia, countenance pale. 
Examination of the lungs revealed moist rales. The urine 
very scanty and heavily loaded with albumen, with occa- 
sional casts visible under the microscope. Abdomen tense 
and evidently containing liquid. Scrotum and penis more 
resembling a large bladder, with a small bladder attach- 
ment, than anything else. Lower extremities swollen al- 
most to bursting. I at once ordered the warm bath fol- 
lowed by hot lilankets. giving medium liberal doses of bi- 
tartrate of potash, with an obligato accompaniment of 
jalap. Free diaphoresis was induced, followed by copious 
watery dejections wdiich. in the course of a few days, re- 
sulted in a complete restoration of the above mentioned 



Original Communications. 21 

parts, excepting the abdomen which, like Banquo's ghost, 
'"would not down." I then determined upon paracentesis 
abdominis, putting the patient upon quinine, syr. ferri. 
iodidi and wine, with good nourishment. The operation 
yielded some twelve quarts of albuminous fluid which, in 
a few days reaccumulated, when tapping was again re- 
sorted to with a similar result. Once more I operated, and 
then left him to recover or die, not calling for eight days. 
At the end of this time I was hurriedly summoned with 
the intelligence that the boy was dying. I found him de- 
lirious, blind, with the same moist rales in the lungs and 
the peritoneal cavity fully distended. I suggested another 
parcentesis in despair, which was reluctantly permitted, 
and the patient fainted as the trocar was introduced. 
The following day I saw him again. He was rational, 
could see and the opening in the abdomen remained 
pervious, allowing the fluid to escape drop by drop. From 
this time he steadily improved, the unpleasant symptoms 
iiever returning. Grradually the discharge ceased, and a 
month after I saw him hoeing in his father's corn field well 
and hearty. The i^athology of croupous nephritis is so 
well known that comment upon that score is scarcely 
necessary. The treatment is, perhaps, open to criticism, 
although the patient recovered. 



Art. Vl.— Practical Hints from Every Day Practice.— By O. B. Will, M. D., 
Dunlap, 111. 

It never fails to be suggestive and profitable for the 
general practitioner to make a note of his various empir- 
ical experiences in the practice of his profession. I have 
done so for several years, and often find my notebook to 
be of as great value to me for reference as are the most 
pretentious volumes on my library shelves. The amount 
of labor incurred in keeping such record is very trivial in- 
deed, when compared with the advantages which accrue 
therefrom. 

To indicate somewhat the character of the memoranda 
to which I refer, and the quiet value which they possess 
for the thoughtful practitioner, I take the liberty to repro- 



22 The Peoria Medical Monthly. 

duce some of them for the consideration of the reader. It 
is true that some of the observations made may, at first 
sight, seem to be of but little practical importance, but I 
have found during a pretty extensive practice, that matters 
of apparently trifling consequence sometimes prove the 
most annoying which we encounter in the pursuit of our 
calling, and that at some time error in diagnosis from a 
superficial examination, has fallen to the lot of every med- 
ical man of my acquaintance. 

TO KEEP THE HYPODERMIC SYRINGE IN ORDER. 

Some months ago I noticed in some periodical, the 
statement that a few drops of glycerine placed in a hypo- 
dermic syringe would prevent, measural^ly, the shrinkage 
of the piston packing when the instrument was not in use. 
I suppose that many physicians have felt the need at times 
of having such instrument in immediate working order. 
I know that I had, until I accidentally discovered the good 
influence of the glycerine in that respect. I have long 
been in the habit of drawing into the Ijarrel each time 
after use, a small quantity of a mixture of one part of 
distilled water to three parts of glycerine, allowing it ta 
remain until the instrument is wanted for use, with the 
advantage of having it always in a servicealile condition. 

' AN UNEXPECTED RESULT. 

A friend who had been quite deaf for about fifteen 
years, applied to me to attempt something tor his relief. 
He had previously consulted a number of physicians in 
regard to his condition, and amongst them an aural special- 
ist of no mean reputation, without, however, deriving anj^ 
benefit from the treatment advised. In order to give me 
time to look up the literature of the subject, and because 
the case was a presumably hopeless one. after a very care- 
less examination I prescribed for him the use, twice daily, 
of an injection into the ear of a liquid consisting of bro- 
mide of potassium, two drachms in eight ounces of rose 
water, to be immediately followed each time l^y the intro- 
duction of four to five drops of a one per cent, solution of 
carbolic acid in glycerine. In something less than eight 
weeks the man came to me with the expression of a pro- 



Original Communications. 23' 

fusion of obligations for having completely restored Ms 
power of hearing. I never was more surprised in my life. 
AVhat the exact pathological condition was I know not. 
There was no discharge from the ear. 

ELECTRICITY IN THE RELIEF OF PAIN. 

A lady came to me complaining of what she denomi- 
nated rheumatism of the shoulder, of over two years stand- 
ing, rendering her left arm almost useless. She had made 
nearly all sorts of applications to the part without avail, 
and had used much medicine internally for the benefit of 
the "liver.*' the latter organ being supposed by some to be 
the primary seat of the difficulty. After making some 
fruitless applications in the way of liniments, I came to 
the conclusion that possibly the case was one of some form 
of cervico-brachial neuralgia, and for the sake of experi- 
ment I would test the influence upon it of a current from 
a magneto-electric machine which I happened to have at 
hand. With the handle from the negative pole held in the 
hand of the afflicted extremity. I passed that, connected 
with the positive, over the back of the neck and down 
across the shoulder, back and front. A pretty strong cur- 
rent was used, and after the first sitting, of half an hour's 
duration, to our astonishment the pain in the shoulder had 
almost disappeared, and at the end of three days it had 
disappeared entirely and has never been felt since, now 
over two years ago. Since that I have had about the same 
result in three similar cases. 

WEANING THE CHILD CURED THE CONSUMPTION. 

A woman within the bounds of my practice, 82 years 
of age and mother of four children, the youngest being 
only five months old, was supposed to be sinking under the 
insinuating presence of an hereditary tubercular tendency. 
She suffered from a severe and most distressing cough, with 
little expectoration, amenable to none of the numerous 
remedies used; loss of appetite, emaciation and night 
sweats, in spite of the diligent use of tonics and anti- 
periodics. It was not considered necessary to wean the 
babe, as it nursed only twice in the twenty-four hours and 
the mother desired it to continue. Finally, however, with 



24 The Peoria Medical Monthly. 

the admonition that it would be for the child's benefit, the 
mother was persuaded to have it kept from the breast. To 
the astonishment of all. the mother immediately be^jan to 
improve, lost her cough, gained rapidh' in strength and 
flesh, and is now hearty and well. She used almost noth- 
ing in the line of medicine but a tablespoonful of whisky 
at each meal time. 



Art. VII.— a Case of Pneunio-Hydro-Thorax. By J. A. Robinson, A. M., M. D., 

Physician in charge of the Department of Throat and Chest Diseases, Cen- 
tral Free Dispensarj', Chicago, 111. 

Gentlemen: In our study of the signs furnished by 
physical exploration of patients having pulmonary diseases, 
we have had opportunity to observe how different patho- 
logical conditions give rise to the different signs. As yet, 
we have had no case to illustrate the signs which are 
present when there is a perforation of the lung, allowing 
air to enter the pleural cavity, causing xmeumo-thorax, or, 
as more frequently termed, pneumo-hydro-thorax. To-day 
I bring before you a x^atient having pneumo-hydro-thorax. 
But let us first recite briefly the history of this case: 

The patient, Niels N^ , a Norwegian, aet. about 30, 

a hostler, has been in ill health for several months. He 
has gradually become emaciated, has a poor appetite and a 
distressing cough. He has been expectorating a thick, 
nummular sputa for some months. 

About two months ago he was seized with chills and 
fever, which lasted about three weeks. His cough became 
more distressing and violent, causing him to lose much 
sleep and to impair his appetite. You see now his ema- 
ciated condition. 

Three weeks ago the following signs were elicited upon 
physical exploration: loss of motion on the right side, in- 
creased vocal fremitus, dullness on percussion anteriorly 
from the second to the sixth rib, extending behind from 
the spine of the scapula to the seventh rib. Numerous 
subcrepitant rales, with bronchial breathing, were heard 
over the area of dullness, with exaggerated respiratory 
murmur over the left side. No cavernous or amphoric 



Original Communications. 25^ 

breathing was perceptible. Last night he was attacked 
with a violent fit of coughing, accompanied by a severe 
stitch pain in the right side. Notwithstanding he took 
anodynes the cough continued all night, together with a 
sense of suffocation. 

Now let us studj^ this case together. By inspection 
you observe the emaciation, his excitability, being in a 
semi-delirious condition, and his extreme feebleness as 
evidenced by the tattoo played upon his teeth as he en- 
deavors to drink from a glass. You notice the loss of 
motion on the right side, with increased movement of the 
left; the bulging of the right side and the position of the 
apex beat of the heart in the fifth inter-costal space, one- 
half an inch to the left of the linea mamillse. 

By placing j^our hands on either side of the thorax you 
notice the absence of vocal fremitus on the right side, with 
loss of motion. 

By percussing in the right infraclavicular region you 
get vesiculo-tympanitic resonance, but when you per- 
cuss below this line, drawn diagonally downwards and 
backwards from the second costal cartilage to the eighth 
dorsal vertebra, you get an intense, pure tympanitic res- 
onance, such as 5^ou get by percussing over a dilated 
colon. Over the lower portion of the pleural cavity we get 
flatness, but as this is over the region of the liver we can 
not say certainly that it is due to effusion, but will investi- 
gate further to see if we find any evidence of liquid being 
in the pleural cavity. 

By auscultation we find on the left side an exaggerated 
respiratory murmur; on the left, above the diagonal line 
mentioned, we get broncho-vesicular breathing, wdth moist 
rales. Below this line cannot distinctly hear any respira- 
tory sound, but we do hear very distinctly with the respira- 
tory movements metallic tinkling, the metallic sounds 
caused by the dropping of liquid into a cavity containing 
fluid and air. Thus we are enabled to say the pleural cav- 
ity contains liquid as well as air. 

This we can also demonstrate by succussion. Place 
your ear on the right side and shake the patient and you 
hear a splashing sound. Hence, you see, we can demon- 



26 The Peoria Medical Monthly. 

strate the presence of air and liquid in the right pleural 
cavity, while the lung is collapsed, being i^ressed upwards 
and backwards. 

Post-mortem. — The patient above referred to lived only 
fifteen hours after he was shown to the class. Upon ex- 
amination the following was found: 

(Aitting through the cartilages of the ribs of the right 
side, there was a sudden escape of air. The lung was col- 
lapsed to its utmost extent considering the amount of 
tuberculous deposit which was found in it. It was pressed 
upwards and backwards. The pleural cavity- contained 
about thirty ounces of serous fluid, in which were flocculi 
of degenerated lung tissue and pus. At a point in the lung, 
corresponding with a point in the fifth inter-costal space, 
midway between the linea mamill^e and the middle of the 
rib. was a cavity in the lung, with a perforation about an 
inch in length. The cavity was about the size of a walnut 
and communicated freely with the bronchioles. An inch 
anteriorily and downwards w^as a second perforation, 
through which a silver probe could be passed. The lower 
and upper lobes of the lung were filled with a cheesey 
tuf)ercular deposit. The heart was normal, although dis- 
placed to the left 

This case is interesting because occuring on the right 
side and in a tuberculous patient, such cases being rare. 



i»oofe iotim. 



Materia 3Iedica and Therapeutics — Inorganic Substances. By C. D. F. Piiii.Lrps, 
M. D., Member Royal College Physicians, Lecturer on Materia Medica, etc., 
etc. Edited and adapted to the U. S. Pharmacopoeia by Lawrenxe .John- 
son. A. M., M. D. Vol. I.; Cloth; 8vo: pp. 298. New York : Wm. Wood 
& Co. 

This is the concluding part of Dr. Phillips" great work 
on Materia Medica and Therapeutics, the first part of which, 
the "Vegetable Kingdom,*' edited by Dr. Piftard, was pub- 
lished by this house in 1879. 

The author devotes considerable space to pharmaceu- 
tical chemistry in connection with each substance, and 
this, we are sure, will be found one of the pleasing features 



Book Notices. 27 

of the work, and one that will make it of great value to 
the student and practitioner. The physiological action of 
medicines is considered necessary in any modern work 
upon this subject, and Dr. Phillips has collected all the 
facts upon this point that are at all worthy of attention. 
Perhaps we can better illustrate his method by transcrib- 
ing from the table of contents a single remedy, for example, 
under "Compounds of Iodine:" 

1, "Absorption and Elimination: 2. Physiological Ac- 
tion, External-Internal; 3. lodiosyncrasy — Toleration; 4, 
Incompatibles: 5, Therapeutical Action. External-Internal; 
6, Preparations and Doses."' and the same method is pre- 
served in the treatment of each remedy. 

The chapters on Water. Sea-bathing and Mineral Wa- 
ters and Baths, are among the most interesting in the work, 
and are very full and complete. 

This work illustrates, b}^ its frequent quotations, the 
great extent to which medical book-writers are indebted to 
the journals. We are glad to notice that the metric system 
is not employed in the book. 

A Reviseil and Enlarged Edition of Clark's New System of Electrical 3Ietli- 
cation. By A. W. TrpTON, M. D., .Jacksonrille. 111. Printed by C. J. .John- 
son & Co., Chicago. Svo: Cloth; pp. 256. 

The status of electricity as a therapeutic agent is 
by no means fairly determined, consequently any work 
that pretends to lay down fixed and certain rules for its 
use, must be largely empirical. The number of recorded 
observations, although seemingly numerous, are yet too 
few for a wide and accurately founded generalization. Still 
we are by no means prejudiced against any theory of elec- 
trical medication that may be advanced, and are always 
glad to read anything that may tend to throw light upon 
the subject. We have read this work with much interest, 
and while not convinced that the author has solved the 
problem of its my.sterious action and wonderful power, we 
imve been interested by the close reasoning manifested 
throughout the preliminary chapters. The whole book is 
interesting reading, and no one will regret the time spent 
in its perusal. Typographically the book presents a fine 
appearance and is first-class in every respect. We believe 
the book will meet with a wide sale. 



28 The Peoria Medical Monthly. 

Pamphlets. 

Moral (Affective) Insanity. A Plea for its retention 
in Medical Nomenclature. By C. H. Hughes, M. D., St. 
Louis, Mo. 

'"Pande" (Charles C. Scott)— A Medico-Legal Record. 
By the same author. Peprint from the Alienist and Nenrol- 
ogist. 

Prevention and Control of Small-Pox, By E. Foster, 
M. D., President Board of Health, Augusta, Ga. Reprint 
from Atlanta Medical Beyister. 



^omty irattisiartiottjsi. 



American Medical Association. 

The thirty-third annual session will l)e held in St. 
Paul, Minn., on June 6, 7, 8. 9, 1882, commencing Tuesday 
the 6th, at 11 A. m. The following list of officers of sections 
may be found useful as reference: 

Section on Practice of Medicine — Chairman, Dr. J. A. 
Octerlony, Kentucky; Secretary, Dr. Deering J. Roberts, 
Tennessee. 

Section on Surgery and Anatomy — Chairman, Dr. J. C. 
Hughes,* Iowa: Secretary, Dr. William A. Byrd. Illinois. 

Section on Obstetrics — Chairman, Dr. H. 0. Marcy, Mass- 
achusetts; Secretary, Dr. C. V. Mottram, Kansas. 

Section on Medical Jurisprudence and State Medicine — 
Chairman, A. L. Gihon, Washington, D. C: Secretary, Dr. 
J. H. Sears, Texas. 

Ophthalmology, Otology and Lary)tgology — Chairman, 
Dr. D. B. St. Jolin Roosa, New York;' Secretary, J. Solis 
Cohen, Philadelphia, Pa. 

Diseases of Children — Chairman, S. C. Buse}\ Washing- 
ton, D. C; Secretary, Dr. William Lee, Baltimore, Md. 

Dentist)!/ — Chairman, Dr. D. H. Goodwillie, New York: 
Secretary, Dr. P. W. Brophy, Illinois. 

Judicial Council — Dr. S. N. Benham, .Pennsylvania; J. 
M. Toner, Washington, D. C; D. A. Linthicum, Arkansas: 
William Brodie, Michigan; H. S. Holton, Vermont; A. B. 
Sloan, Missouri; R. Beverley, California. 

Committee on Arrangements — Dr. A. J. Stone, St. Paul,, 
Minn., Chairman. 



Society Transactions. 29 

Ethical Resolutions Passed by the St. Louis Medical Society. 

The following resolutions were adopted by the St. 
Louis Medical Society April 1st, 1882: 

Besoli-ed, That the St. Louis Medical Society, while it 
desires to accord the broadest freedom to medical investi- 
gations and recognizes fully the right of individuals to form 
and hold private opinions, hereby declares that it regards 
with disfavor any steps taken to lessen or obliterate the 
distinctions and safeguards between an honorable practice 
of medicine founded upon science and that founded upon 
any of the current delusions and exclusive medical systems 
of the day. 

Besalved, That a copy of this resolution be forwarded 
by the Corresponding Secretary to the New York State 
Medical Society, to the Permanent Secretary of the Amer- 
ican Medical Association, and to several specified medical 
journals. Wm. Dickinson, M. D., 

A. H. Ohmann-Dumesnil, M. D., President. 

Recording Sec ) -eta f -tj. 



De Witt County Medical Society. 

At the annual meeting of this society at the office of 
Dr. J. M. Wilcox, in the City of Clinton, on the 11th day 
of April, 1882, the following officers were elected for the 
ensuing year: 

President— John Wright, M. D. 

Vice President— J. M. Wilcox, M. D. 

Secretary and Treasurer — C. Cloodbrake, M. D. 

Censors— W. H. Kirby, M. D.; J. J. Starkey, M. D., and 
J. A. Edmiston, M. D. 

Delegates to the Illinois State Medical Society — J. H. 
Potter, M. D.; W. H. Kirby, M. D., and J. D. Gardiner, M. D. 

Delegates to the American Medical Association — John 
Wright, M. D., and A. W. Edmiston, M. D. 

C. GooDBRAKE, M. D., Secretcni/. 



Peoria City Medical Society. 

The following delegates were chosen to represent this 
Society at Quincy and St. Paul: 

To the American Medical Association — Drs. H. Steele 
and J. Stout. 

To the State Medical Society — Drs. John Murphy, 0. B. 
Will, J. S. Miller and T. M. Mcllvaine. 



30 The Peoria Medical Monthly. 

At a meeting of the Peoria City Medical Society, held 
on Tuesday, May 2d, 1SS2, the following preaml)le and res- 
olutions were unanimously adopted: 

Whereas, We have learned with unfeigned regret of 
the sudden demise of Doctor Hodgen. of 8t. Louis, cut off 
in the prime of what appeared an unusually vigorous life, 
and in the very zenith of a w^orld-wide professional fame, 
another victim of a too assiduous performance of his 
duties to the public and to science; therefore, 

Besolred, That we only feebly express our sentiments, 
and those of the profession in Central Illinois, in register- 
ing our profound regret at the untimely death of a surgeon 
in every respect so eminent, and at the irreparable loss 
which his family, the profession, and the public have sus- 
tained by that melancholy event. 

Besolri'd. That a copy of these resolutions be forward- 
fid to thfi family of the deceased. 

J. L. Hamilton, President. 

J. Stout. Secretanj. 



• 

i'odeia in Dysmeuorrhoea, Sleeplessness and Malarial Headache. 

Case 1. — I was consulted by the mother of a young lady 
of 18 years who, she stated, had suffered with painful men- 
struation for the past tw o years. The pain was so great 
that she neither got rest nor sleep during her periods. After 
putting her under a general medical treatment, I ordered 
opium to relieve the pain, but it disagreed with her sensi- 
tive stomach. Morphia was no better, though I used it 
hjqDodermically. It was then I decided on codeia, in one- 
fourth of a grain doses, and had the pleasure of seeing my 
patient f)erfectly relieved. Her ])ain disappeared and a 
calm sleep was induced. From this happy result I decided 
to try it on another case, wdiere morphia had played a 
prominent role and had failed. 

Case 2. — A lady, 35 years, unmarried, was subject to 
dysmenorrhoea to such an extent, that she had to keep her 
bed during four days of her catamenia. I ordered codeia, 
in one-fourth of a grain doses, morning and evening, with 
prompt relief. 

Case 3. — Married lady, 40 years old. complains of dis- 
tressing pain during her catamenia. About two years ago 
she aborted at fourth month, and had suffered to a greater 
or less extent ever since, at her regular returns. Phvsical 



Periscope. 31 

examination showed an ulcerated os and an anteflexed 
womb. While treating the last two affections, I adminis- 
tered codeia to relieve her pains with the same unfailing 
and pleasant result. 

Encouraged by these experiences, I prescribed it in a 
case of mania-a-potu, and in twenty minutes my patient 
was calmed, and upon the repetition of the dose he fell 
asleep. 

Again in a case of great exhaustion, in a gentleman 
who had to take twenty grains of hydrate of chloral, with 
one drachm of bromide of potassium, in order to obtain 
an hour's sleep, I ordered one-fourth of a grain of codeia, 
to be repeated in twenty minutes, and for the first time in 
four months that gentleman enjoyed four hours of unbroken 
sleep. I have used it also in the distressing headache that 
accompanies malarial lever, and always with the most 
:flattering results. — Ohstet. Gazeffe. 



A Modification of Lister's Antiseptic Dressing. 

Dr. James L. Little has for several years been surgeon 
to a large factory in New York, in which three thousand 
hands are employed, and where injuries by machinery are 
<iuite freciuent. These injuries consist chiefly of wounds 
of the hands and fingers, caused by their being caught in 
cog-wheels and other parts of the machinery. In many 
cases the fingers are torn off, tendons are pulled from their 
sheaths, joints are opened, and the hands are often severe- 
ly crushed and lacerated. In all of these cases he has, for 
the past six years, been using the following simple anti- 
septic dressing: Having put the parts in condition for 
dressing, he washes the wound in a solution of carbolic 
acid of the strength of one to twenty: he then covers the 
parts with a thick layer of l)orated cotton, and then snugly 
and evenly applies a simple gauze bandage. -At first he 
used bandages of antiseptic gauze, but for the past three 
years has used those of plain uncarbolized cheese-cloth. 
These thin bandages distrilnite the pressure more evenly 
over the cotton, and are more easily saturated with fluids 
than those made of unbleached muslin. The patient is in- 
structed to keep the outside of the dressing wet with a 
solution of carbolic acid of the strength of one to one 
hundred. The author employs Squil)lVs solution of impure 
carbolic acid, which is of the strength of one to fifty, and 
which, when mixed with an equal bulk of water, gives a 
solution of the desired strength. The parts should be kept 
at rest, and the dressing may be left undisturbed for sev- 



32 The Peoria Medical Monthly. 

eral clays, unless there is pain, rise ol temperature, or dis- 
charge through the dressings. These conditions are always 
to be considered indications for renewing the dressing. In 
many cases where rubber drainage-tubes have been used 
they may be removed at the second dressing, and, if catgut 
has been used for sutures, this second dressing can be 
allowed to remain on for an indefinite period. In a num])er 
of cases of lacerated wounds the first dressing has been 
allowed to remain on until the wound has entirely healed. 
In these cases the external use of carbolic lotion was dis- 
continued after the fifth or sixth day, and the dressings, 
would l;)ecome dry and hard, the wound healing, as it were. 
"* under a scab.'' The patient should be instructed to 
loosen the bandage at once if any pain occurs. Out of 
nearly three hundred cases of open wounds involving the 
fingers and hands, thus treated, not one has been followed 
by infiammatory symptoms. Extensive lacerated wounds 
have healed, and dead tissue sloughed away, without giving 
rise to any of the so-called symptoms of infiammation. 
Neither pain, redness, heat, swelling, nor constitutional 
disturbance has resulted. In no case has there Ijeen red- 
dening of the lymphatics or tenderness of the glands. No 
counter-openings have been necessary. Pain has been en- 
tirely absent, so that anodynes have not been needed, save 
in a single case, and that for one night only, and to control 
slight restlessness. The author thinks these results the 
more remarkable from the fact that many of the patients 
were in an unhealthy condition, some suffering from 
anaemia, some from cardiac disease, phthisis, and the like- 
After giving a case of amputation of the leg. exemplifying 
the method. Dr. Little expresses the opinion that the value 
of cotton-wool as an antiseptic dressing is not fully appre- 
ciated. Used in the way he has indicated, it seems to be 
as perfect an antiseptic dressing as the gauze and other 
materials recommended by Mr. Lister, while at the same 
time it is free from all objections that pertain to the latter, 
and which materially hinder their use l)y the general prac- 
titioner. If supplied in sufficient quantities around an 
open wound, it protects it thoroughly from the "floating 
matter of the air," which is supposed to be the real inciter 
of suppuration. It is the best germ-filter known to us. 
To insure success in cases where the dressing is used, full 
. precautions as to rendering the instruments, sponges, and 
the hands of the surgeon aseptic, and the use of drainage 
tubes, if necessary, should not be neglected. Catgut or 
torsion should be used to arrest hemorrhage. The spray 
may be resorted to, if necessary. At the second dressing 



Periscope. 33 

the author now usually applies carbolized oil, of the 
strength of one to twelve, to the wound to facilitate the 
removal of the cotton, which is otherwise apt to adhere 
after the first dressing. — N. Y. Med. Jour, and Ohstef. Bev., 
Dec. '81, (Old Courier of Med. 



Treatment of Epilepsy. 

M. Ball, the present professor of mental diseases at the 
Paris School of Medicine, considers that the drug's most 
used in epilepsy prove much more efhcacious wdien taken 
in combination with each other, than when one of them is 
administered singly. The alkaline bromides, particularly 
the bromide of ammonium, with belladonna and oxide of 
zinc, form the basis of treatment. 

The following solution \\\^j be given, in tablespoonful 
doses : 

3 Ammonii briniiid., 2}4, drachms. 

Sodii bromid., 2^., dracliras. 

Aqune destil., 10 ounces. M. 

At the commencement ol treatment four tablespoons- 
ful of this solution may be taken during the da}-, and the 
dose increased to eight or ten tablespoonsful if no appreci- 
able effect is noticed after a few days. 

Belladonna and oxide of zinc are administered in pill 
form, as follows: 

5 Ext. belladoniife, 15 grains. 

Zinoi ozid., 15 grains. 

M. Ft. pil xl. 

Sig. One pill may be taken in the morning, another 
in the evening, at first: then the dose may be increased to 
four pills per diem. 

If any degree of plethora exists the drastic purgatives 
should be resorted to. and in some cases benefit is obtained 
from a general bleeding, or the application of leeches to 
the temples or behind the ears. 

M. Ball gives the following formula for drastic pills: 

5 Aloes, 15 grains. 

Seammon. resin, T^^^a grains. 

Jalapte resin, 1% gi'ains. 

Calomel, 7)-| grains. 

Saponis medic, q. s. 
M. Ft. pil. xxiv. 

Sig. These pills are to be taken once a week, three in 
the morning and as many more about noonday. 

What is of importance to notice is the immediate ben- 
eficial effect of this combined treatment: this is sometimes 
remarked on the second day. 

This method, like all other forms of treatment of epi- 
lepsy, should be continued for a long period, and should 



34 The Peoria Medical Monthly. 

not be suddenly stopped; the doses should be progressively 
and slowly diminished when it is considered safe to lay 
aside the treatment. — Pliil. Med and Siuy. Beporfer. 



Hour-Glass Contractions of the Uterus Treated with Nitrite of 

Amyl. 

Dr. Fancourt Barnes reports a case in the British Medi- 
cal JouruaU which is of considerable interest. He was 
called to a case of retained placenta, in which the midwife 
in attendance had given a dose of ergot as soon as the 
child was born, with the effect of contracting the os in- 
ternum. As it was impossible to get his hand into the 
uterus, he determined to test the nitrite of amyl. three 
drops of which w^ere inhaled from a handkerchief. During- 
the inhalation the ring of muscular fibres around the os 
internum, which had been so rigid as to be absolutely un- 
dilatable, steadily yielded, until he passed his whole hand 
into the uterus and detached the placenta, which was uni- 
versally adherent. There was no hemorrhage, wdiatever. 
and the placenta itself presented a remarkably exsanguined 
appearance. Dr. Barnes thinks in this agent we have the 
long-w^ished for antidode or opposite force to ergot. 

It acts as a sedative and ansesthetic without producing 
unconsciousness. 



The Ahini Plug- in Uterine Heniorrhage. 

Dr. R. W. Griswold, Connecticut, says: 

For the last twenty years my reliance has been on a 
junk of alum in the vagina. If this is not at hand I take 
the next best thing that is: but a junk of alum is part of 
the contents of my medicine box. It is of the size of a 
large hen's egg, oviod in shape, and generally left a little 
ragged, though without sharp points. Around the middle 
is cut a groove, about which is tied a bit of strong but not 
large twine, leaving the ends so that the}" can hang out of 
the vagina. This treatment is easy, speedy, and effectual 
against further hemorrhage. It has never failed me, and 
I leave a patient with a feeling that she is safe for the next 
twelve or fifteen hours, so far as danger from further bleed- 
ing is concerned. And I may add that I have never had 
any unfavorable effects follow its use in any one of the 
scores of cases in which it has been employed — no fevei'S» 
no septicemia, no deaths, no anything ontoward — and I 
have never had occasion to use it the second time in any 
one case. — Western Lancet. 



Periscope. 35 

On Abuses of the Jacket-Treatment of Spinal Disease. 

The writer, while acknowledging fully the debt Euro- 
pean surgery owes to Dr. Sayre for the able advocacy of 
his treatment, and granting that it is due to his exertions 
that in England it has come into such general use, consid- 
ers that in many cases the jacket is hastily and needlessly 
applied, and that its employment is often actively harmful. 
He divides the cases in which the jacket-treatment is 
abused into two classes: A. Those due to a wrong selection 
of cases; B. Those due to wrong methods of application of 
the jacket. 

In class A the following are given as improper in- 
stances: 

1. Simple rickefij spines, often mistaken for cases or of 
commencing caries. 

2. Cases of simple lateral earrafure. in which the dis- 
ease is perpetuated by the use of rigid support. 

3. Certain eases af true spinal earies. In infants during 
the early progress of the disease the older plan of rest and 
horizontal position succeeds better than does any attempt 
to immobilize the spinal column, it is free from the risk of 
preventing due development of the trunk; but the jacket 
may be used from the first in older children with or with- 
out confinement to bed. 

4. Cases in which the lungs or heart are aftected. in 
addition to the afl:ection of the spine. 

5. Cases in which the carious spine is associated with 
any high degree of paralysis, incontinence of urine, etc. 

In class B the following are the chief instances of mis- 
application of jackets: 

1. Undue heariness, many jackets being far too thick 
and strong. 

2. Use of the swing. This apparatus is considered to 
be, for children, useless if not harmful, the object of exten- 
sion being to allow the body to hang as straight as it ma}' 
while avoiding all risks of disturbing any adhesions be- 
tween consolidating vertebrae, and to bring the chest-walls 
into a condition of extreme aspiration. It is held that 
these objects are best attained by holding the child by the 
arms with the feet on the floor, or by the use of an inclined 
plane. 

3. Bad fitting and had shaping of the jacket. More 
especiallj^ neglect of the inspiratory position of chest-walls, 
insufiicient hold of the jacket on the pelvis, and inaccurate 
fitting to the spinal curve or angle. — Walter Pye, F. B. S., 
in Amer. Jour, of Obstetrics. 



36 The Peoria Medical Monthly. 

Aiiiyl Nitrite for Ague. 

Dr. Saunders, of Indore, India, reports in the Indian 
Mcillcal Gazette, a number of cases of ague successfully 
treated "with amyl nitrite. He asserts that in every 
instance the disease yielded quickly and permanently to 
the amyl treatment. He mixes the drug with an equal 
volume of oil of coriander, to make it less volatile and to 
cover its odor, and administers it as follows: Four drops 
of the mixture are poured on a small piece of lint, which 
is given into the hands of the patient for him to inhale 
freely: he soon becomes flush, and both his pulse and res- 
l^iration are much accelerated, and when he feels warm all 
over, the inhalation is discontinued, as the symptoms con- 
tinue to increase for sometime afterward; a profuse perspi- 
ration now sets in, whi(di speedily ends the attack, though 
in some cases the cold stage merely passes off without any 
hot or sweating stage. — Therapentie (razette. 



The Treatment of Acute Piieiinioiiia . 

Surgeon Deakey states that pneumonia occurring in 
the natives of India is very frequently of an asthenic, and 
often of a latent type. It is particulai'h^ intractable to 
treatment. He has therefore been led to employ belladon- 
na in such cases, and has been much impressed by the good 
results wdiich have attended upon its use. Surgeon Deakey 
attaches much importance to full and regular action of 
the bowels whilst the belladonna is being administered, 
and to insure this he gives magnesium sulphate in addition 
to potassium, bromide or iodide. The combination of irou 
with belladonna also tends to induce apro^^er action of the 
bowels. If there is much muco-purulent expectoration, it 
is advisable to give an ipecacuanha emetic before com- 
mencing the belladonna treatment. — The Practitioner. 



Salicylic Acid as a l>ry Surgical Dressing. 

Dr. F. E. Daniel (Missis.sijjpi Vat let/ Medical Monthln) 
has had remarkable success with this drug, having used it 
in a large number of cases after operative procedure, and 
finds it to l)e useful in controlling or overcoming pain. It 
is a good antiseptic, clean, and in the doctor's hands has 
proved of very great value. After operation the wound is 
covered with the acid, used in natural state, a dry powder, 
and the usual dressing applied. No air is allowed to get 
into the wound if possible. Entire absence of pain is the 
most noticealile feature. 



Therapeutic Notes. 

ilterapcutir gloteis. 



37 



H.ICMOSTATrC PILLS. 

The follow ing formula is highly 
recommended for hemorrhages of diff- 
erent kinds, such us metrorrhagia, epis- 
taxis hemoptysis, etc. : 
5 Ergotin, 

Quinia sul., aa. }o drachm 

Digitalis, 

Ex. hyoscyami, aa. 5 grains. M. 

Ft. pil. No. X. Sig. One pill every 
two, three or four hours. — Journal de 
Theriiptvtique. 

IODINE PAINT FOR CHRONIC PAINS. 

S lodini, 40 grains. 

Pot. iodidi, 30 grains. 

Spts. vini rectiticat, 1 ounce. M. 

To be applied with a camel's hair 
pencil. 

DIAPHORETIC IN SEA ERE CATARRH WITH 
SORE THROAT. 

B Potass, nitratis, 00 grains. 

Vel. potass, citratis, 120 grains. 

Yini ipecac, 2 drachms 

Syr. hemidesmi, 1 ounce. 

Decoc. hordei, ad 1 pint. M. 

Sig. One .small teaspoonful to he 
taken every two or three hours. 

RINGWORM. 

Two or three api)lications of the fol- 
lowing at intervals of eight to ten days 
■will frequently effect a cure in ring- 
worm : 

5 lodini, 120 grains. 

Olei. petrolei allii, 1 ounce. M. 

Apply with a firm brush. — Mediral 
■GazetU. 

UTERINE DISPLACEMENTS. 

Astringent cotton tampons satura- 
ted Mith a solution of glycerine, alum 
and carliolic acid, are recommended in 
treatment of uterine displacements in 
place of pessaries, stems, etc. — Monthly 
Reciew. 

LEUCORRHCEA. 

5 Zinci oxidi vel. bismuth 

subnit., yO grains. 

Ex. belladonna, 40 grains. 

01. theobromai, 1 ounce. 

01. olivo:', 3 drachms. 

M. Divide into eight suppositories 
and order one to be used every night. 
— Southern Med. Record. 

CATARRH AND IRRITABILITY OF THE 
BLADDER. 

^ Liquor potass*, 10 minims. 

Tr. hyoscyami, 40 minims. 

Infus. buchu, 12 drachms. M. 

Make a draught to be taken three 
times a day. — New England. Medical 
Monthly. 



ANTISEPTIC 9TIMUL.\NT IN TYPHOID. 

5 Rum, 9 ounces. 

Creosote, 2 drops. 

Phenic acid^ 4 grains. 

Salicylic acid, 15 grains. M. 

Small cjuantities may l)e given as re- 
quired. This is proposed to prevent 
purulent infection from the intestinal 
lesions. — Mich. Med. News. 

IODINE CAUSTIC. 

This preparation has been used in 
the treatment of lupus. It contains: 
I^ Iodine, 1 ounce. 

Gh'cerine, 2 ounces. M. 

It is applied every second dav with 
a camel's-hair brush, but as the prepa- 
ration is very powerful its action re- 
quires to be carefully watched. 

NOCTURNAL INCONTINENCE OF URINE 
IN CHILDREN. 

^ Strychni*, 1 grain. 

Pui. cantharides, 2 grains. 

Morph. sulph., l^^ grains. 

Ferri ruls., 20 gi-ains. M. 

Make from 40 to 50 powders or pills. 
Sig. One three times a day to a child 
ten years old. — Canada Lancet. 

C4ASTR0DYN'IA. 

B Bismuth subnit., 4 scruples. 

Morphia sulph., 1 grain. 

Potass, cyanuret., 2 grains, M. 
Div. in Chart Number 16. Sig. 
One after eacli meal.— J/«/. Bulletin. 

ERYSIPELAS. 

The following local application re- 
lieves the Ijurning pain and heat in this 
disease more quickly than anything the 
writer has ever tried, and at the same 
time exerts a positive curative influence: 
B Borax, 1 drachm. 

Glycerine, 1 ounce. M. 

Apply freely over the affected parts. 
The effects are attributed to the anti- 
septic influence of the borax, and the 
deptu'ative action of the glycerine. 

MISTUTIA APII COMPOSITA. 

^ Fl. ex. coca, 2 ounces. 

Fl. ex. black-haw. 2 ounces. 

Fl. ex. celery seeds, 1 ounce. M. 
Dose — as a nervous tonic, from one 
to two teaspoonsful three times a day. 
— Druggists Circular. 

INFLAMED CON.rUNCTlVA. 

5 Tannin, 10 grains. 

Sodte 1)icarb., 20 grains. 

Glycerine, 2 drachms. 

Aqua?, 2 pints. M. 

Use with an atomizer in the form of 
a spray. — Louisville Med. A ews. 



TxaiE 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South- Jefferson Street, .... PEOBIA, ILL. 

,•* All exchanges, books for review, and communications must be addressed to the 
Editor and Publisiier. 

***The publication day of this journal is on or about tlie 10th of each month 
»**To subscribers! A pencil marli at this place indicates that the timeof your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



€ditoml gfpartm^ttt. 

A'oliinie III. 

With this num])er we begin the third year of this 
journal, and desire at this time to express our heai-ty 
thanks to those who have aided us in our work. Our his- 
tory has been one of success only, and a success that is in- 
creasing with every month. We do not say this in a vain 
spirit, for we realize that without the support, financial 
and literary, of the profession, our historj^ would have 
been a short one. Far beyond our utmost expectations 
have w^e received this aid, and we have endeavored as best 
w^e could to make this journal worthy of it. Three times 
have its pages been enlarged, and their numbers increased, 
until now we offer a yearly volume ot over oOO pages, for 
the same amount that we asked at first tor one of but 300 
pages. No pains have been spared in making the appear- 
ance of the journal worthy of its thousands of readers: 
paper has been manufactured expressly for our use; new 
type purchased, and skilled labored employed, until now 
we are not ashamed or afraid of a comparison with any. 

To those gentlemen who have contributed of their 
knowledge and experience we owe a heavy debt of grati- 
tude, and can only express the hope that during the coming 
year this debt may be vastly increased. 



Editorial Department. 39^ 

The New York Code of Ethics. 

We were not mistaken, when we predicted that the 
late move of the New York State Medical Society would 
be severel}^ handled both by the medical press, and other 
medical societies. The Medical Record, which is the cham- 
pion of the new departure, and which even claims to be 
the originator of it all, in a late editorial claims that so far 
no argument has been brought to bear against the new 
code; that all that has been advanced has been vitupera- 
tion and bombast, born of jealousy, and that all impoiiant 
societies would adopt the same course. 

The Centur//, late Scribner\s, has a puerile fanfaronade 
of the same kind. In reply to these, we can point for 
argument to an editorial in the April number of the Chi- 
cago Medical Joanial and Examiner, which could only 
come from the trenchant pen of Dr. N. S. Davis. The 
arguments he brings forth are simply unanswerable, and 
to them we invite the Record's attention. 

So far as the action of the various societies is con- 
cerned, it is yet too early to state definitely what that will 
be; but we call attention to the action of the St. Louis 
Medical Society, iDrinted elsewhere in this number, whose 
resolutions possess the true ring of professional honor. 
Some silly fool has even gone so far as to claim, that the 
New York State Medical Society could get along far better 
without the American Medical Association, than could the 
American Association without the New York Society. The 
fight bids fair to be a short but hot one, and the result can 
be easily predicted. If the Committee on Credentials at 
the St. Paul meeting in June but do their duty, and the 
Judicial Council back them up, the delegates from the New 
York State Medical Society will not be permitted to take 
seats in the convention, and the majority of regular phy- 
sicians in the w^orld will say, amen ! 

If the members of that State Society wish to sever 
their connection with the American Association, they have 
a perfect right to do so, but they can claim no right, mor- 
ally or legally, to enact laws fundamentally opposed to 
those of the larger society, of which they form but a part, 
and still hold representation in that body. 



40 The Peoria Medical Monthly. 

An Error Corrected. 

It is evident that we have not done enough 1)1 owing 
about our circuhition. Some seem to have an idea that 
this journal is very limited in its circulation and merely 
local in its range. This is not so. We are satisfied that 
our circulation, which is over two thousand copies each 
month, is excelled but by very few in the West, and ])y not 
a veiy great number in the East. By referring to the re- 
ceipts which are printed each month, one may discover 
that we also reach almost every state and territory in the 
country. The numl)er of our readers will not fall far short 
of three thousand each month. We mention these facts to 
prove to some, that should they contribute to our pages, 
they will have an audience worthy of their best efforts, 
and one that is increasing by nearly one hundred every 
month. 



T<t Coiitributor.s. 

In writing articles for journals it is important to culti- 
vate brevity. Short, spicy articles, just full enough to 
convey the idea of the writer, with the true ring of busi- 
ness in them, attract far more attention and are more gen- 
erally read than those of greater length. It is this kind of 
articles that we especially desire, and invite ouk friends to 
contrilmte. We are compelled to decline many articles on 
account of their length. After you write a paper, read it 
over carefully and cut out all that you think can possibly 
be spared, and we will guarantee that it will I^e read with 
pleasure by thousands. We hope our friends will send us 
short practical articles, and plenty of them. 



Insanity from Druji's. 

Members of the medical profession, especially those 
having had dealings with the insane, are earnestly request- 
ed to answer the following questions, fully, yet concisely. 
The subject is one of so much importance, medico-legally, 
and otherwise, and so very little is to be found upon it in 
works on insanity, that it merits the attention asked for it: 



Editorial Department. 41 

1. Have you ever seen any cases of insanity, temporary or perma- 
nent, or any deviation from the normal mental or moral state that could 

, be traced directly to the use of a single large dose, or the continued use 

of OPIUM, OR AX Y OF ITS PREPARATIONS OR ALKALOIDS ? 

2. Of what type -was such insanity ? Give symptoms. 

3. State patient's age, sex, civil condition, and occupation. 

4. AVhat was its duration and result ? 

5. State color of patient's hair, eyes, and complexion. 

6. Was there any hereditary tendency to insanity, or any historv 
of alcoholism, grave nervous disease, or any drug habit in the patient's 
ancestors ? 

7. What amount of the drug was used, and for how long a time? 

8. What line of treatment was pursued? 

9. Please answer the same questions regarding the use of chloral 

HYDRATE. 

10. Please answer the same questions regarding the use of bromide; 
of potassium, or any other drugs. 

Stamps will invariably be returned. In all cases so requested, com- 
munications will be considered strictly confidential. Reprints of the 
article, embodying the results of such statistics, will be sent to each cor- 
respondent. Address, Dr. H. H. Kane, De Quincy Home, Fort Wash- 
ington, Xew York City. 



Notes and Xews Items. 



The eminent >!cientist. Charles R. Darwin, died April 

20th. 

The new Women's College, at Baltimore, has all male 
professors. 

The Missouri State Medical Society will meet at Han- 
nibal. May 16th. 

The death of Dr. John T. Hodgen. of St. Louis, robs 
the AVest of its most famous surgeon. 

The annual meeting of the Military Tract Medical 
Society was held in Monmouth, 111., May 9th. 

Every Western physician should subscribe for a "home 
journal."" This is one: suppose you try it for a year. 

Dr. Mark Ranney. Superintendent of the Iowa Hos- 
pital for the Insane, died of an attack of pneumonia, Jan- 
uary 13th. 

Logan County. Hi., has a County Medical Society, 
lately established and now in good working order. We 
hope the interest so strongly manifested in it now will not 
be allowed to die out. 



42 The Peoria Medical Monthly. 

Drs. S. W, Gross and John H. Brinton have been chosen 
to fill the chair in Jefferson Medical College, made vacant 
by the resignation of the ''Nestor of American Surgery," 
Dr. S. D. Gross. The appointments give general satisfac- 
tion. 

The Brainard District Medical Society met in Mason 
City, 111., on April 27th. The report of proceedings reached 
ns too late for this issue, but will appear in our next, to- 
gether with the address of the retiring President. Dr. S. T. 
Hurst. 

The Neir Euijlaud Medical Monthlij is becoming as 
strongh' partisan as the Therapeutic Gazeffc, which it so 
bitterly attacked. Such a course will rob it of any influ- 
ence which it might otherwise have gained as an independ- 
ent medical journal. 

A Chicago professor stated in a lecture that he had 
noticed that in sterile women the hair on the Mons Veneris 
was always straight. The professor was rather surprised 
by the inquiry of a student, whether curling the hair 
would cure the sterility? Fact. 

Dr. Erskine Mason, a prominent sui*geon of Xew York 
city, died on April 13th. aged 45 years. Dr. Mason was 
quite a writer, and his papers on '•Operation for Strangu- 
lated Hernia, without Opening the Sac," ''Lumbar Colot- 
omy/' '"Laparotomy." etc., attracted wide attention. 

W. F. Albright, Esq., music dealer and publisher of 
Bloomington, 111., sends us a copy of his Standard Musical 
Library. Each number of this librar}^ contains five or six 
pieces of first-class music, such as retails usually at thirty 
cents each. Mr. Albright's price is cjuhf tirehe coit.^i for 
11.50 worth of music. This is equal to dime medical lit- 
erature. 

The Central Illinois Medical Society had a full meet- 
ing in Bloomington on May 3d. More than ordinary inter- 
est is taken in this society by its meinl;)ers. as evinced by 
the work done. This society is now next in size to the 
State Society, the usuc>l number in attendance running 



Editorial Department. 43 

from sixt}^ to seventy-five. The physicians of Bloomington 
tendered the society an elegant banquet in the evening at 
the Phoenix Hotel. We hope to have a full report of the 
j)roceedings of the society for our next issue. 

Dr. J. H. Patton. of Richmond, Ya.. is to answer Dr. 
Palmer's book on " Homoeopathj^ — What it Is," through the 
pages of the SoHtliern Clhu'c. It is said that Dr. Patton is 
a graduate of both allopathic and homoeopathic schools, 
and something lively may be expected. 

Dr. Ranch, Secretary of the State Board of Health, 
has distributed postal card blanks for reports of vaccina- 
tions. If properl}^ filled out by physicians and returned to 
the Secretary, they will be valuable aids to the preparation 
of statistics upon this subject. Dr. Ranch has sent a quan- 
tit}^ to this office, and any who have not yet received them 
maj' obtain one or more by dropping a card to the editor. 

The Post-Graduate Faculty of the University of New 
York, comprising such names as W. A. Hammond, D. B. 
St. John Roosa, M. A. Pallen, F. R. Sturgis, H. G. Piffard, 
and others, recently handed in their resignations. Differ- 
ence of opinion between this Faculty and the regular gov- 
erning Faculty as to matters of policy and jurisdiction led 
to this step. We hope it does not portend the establish- 
ment of a new college. 

The University pf Yirginia evidenth' believes in qual- 
ity rather than numbers of its medical graduates. For the 
two college years ending in ISSO, there were 79 applications 
for the degree, but only 31 of this number were graduated. 
The medical departuient of the University of Pennsylvania 
rejected 23i per cent, of the candidates for graduation at 
the recent examinations. We hope this weeding out 
policy will become epidemic. 

A private letter from a rained correspondent contains 
the following, which is too good to be lost. He writes: 

"I see Dr. Byford has greatly improved his w^ork on 
Diseases of Women. In the first edition ' Nitrate of Silver 
and its substitutes " played a very important part. When 
I lived in . a lady friend visited Chicago and spent the 



44 The Peoria Medical Monthly. 

summer there. On her return, I met her in the company 
of several hidies, who brought up the subject of complex- 
ion. The lady was asked if she had noticed the well- 
known fact that Chicago ladies were less fair than their 
Eastern sisters, and that Eastern ladies who A\'ent to Chi- 
cago soon lost their complexion, and if she thought the 
climate was the cause.' The lad}' replied that she had no- 
ticed the fact and thought the climate might have some- 
thing to do with it. but she had given the subject consider- 
able attention, and had concluded that the reason in part 
was due to the fact that Dr. Bytbrd treated female diseases 
exclusively with nitrate of silver. I judge, therefore, from 
his last edition, that the complexion of Chicago ladies will 
now improve."' "*' =!= :i; * >^ 

With the new volume begin your subscription to The 
Peoria Mewcal Monthly. 



The White Mountains Excursions. 

In the Detroit Erening Netrs of March 3d. an advance 
announcement is made of the sixth season of excursions 
"From Detroit to the Sea."" There will be three in num- 
ber, and will leave Detroit on the mornings of July 5th, 
20th and 27th. and tickets will be good to return any time 
before September 4th. The route is to be via the Grand 
Trunk Railroad and St. Lawrence River steamers, through 
the Thousand Islands and famous Rapids to Montreal, 
thence to the White Mountains and sea shore at Portland. 
Maine (near Boston), ^n the return trip. Quebec, Niagara 
Falls and Butialo are to be included, making altogether a 
trip of over 2,000 miles for $20. Each of the excursions 
will be conducted by W. H. Brearley, who has taken seven 
parties over the same route in former years, and who last 
year successfully managed three excursions. The trains 
are "special" trains of Pullman Palace cars, and upon the 
St. Lawrence River a special steamer will be used. A 
handsome guide book giving full descriptions and illustra- 
tions of this route, may be obtained for 80 cents by writing 
to Mr. Brearley, ofHce Detroit Evot'nuj Xe/rs. Over 40 
maps have been engraved for this edition, and the title 
page is an exact copy, in colors, of an oil painting of Glen 
Ellis Falls, near the Glen House, in the White Mountains. 



Editorial Department. 45 

Bound Volumes— Special Oflfer. 

There are about thirty-five complete sets of volume II 
at this office. To accommodate some who have expressed 
a desire to have the volume bound, we will make the fol- 
lowing offer: 

We will furnish volume IL bound in regular library 
stjde (heavy boards, leather back and corners), iogefhe.)' uith 
volume III, for Two Dollars, cash to be sent with the order. 
Volume II inakes a fine octavo volume of 520 pages. 

Those who wish to avail themselves of this offer will 
please send their orders in at once, as we can only obtain 
this low price by having a number bound at one time. If 
any wish to have their copies of volume II bound, we can 
have this done for them in the same style at 90 cents each, 
and will pay the return charges. 

The edition of number 2. volume I, is long since ex- 
hausted, and we are unable to offer complete sets of that 
volume. 



•^ Receipts for April. 

In this place we will print the names of those from 
whom money has been received during each month. 
Parties remitting will please note whether their names are 
credited, and if they are not, notify us by postal card : 

Illinois— Drs. G. G. Case, John Becker, I. W. Waters, F. .J. Sliipp, E. Hol- 
derness, W. VV. R. Woodbury, J. B. Bell, E. T. Purdum, J. F. Ball. A. W. Green, 
W. Becker, R. X. Barnes. E.' Blancliard. W. O. Ensign (3 years), B. F. Buckley, 
S. T. Anderson, O. P. Pauldina:, P. A. Rosenberojer,' J. B. Miller, Robert Boal, 
Silas Hubbard, J. H. Timkins, F. C. Vandervo^t, J. T. Stewart, J. R. Snelling, 
W. E. Haines, Charles Fisher, C. D. Henton, G. W. Dunlap, A. D. Brown, M. D. 
Til)betts. C. F. Ross, W. J. <& C. Chenowith, H. Gulick. Fell & Graham, N. B. 
Hoornbeck (2 years), J. S. Blankenship, H. T. Cotfey, Thomas Temple, 31. Reece, 
W. X. Cline. F. M. Skinner, J. B. Carver, W. H. Coiiibear, A. S. Core, Thomas H. 
Line, G. Uorn, J. L. Martin, J. P. Walker, F. Cole, D. M. Slemmons, O. B. Will, 
P. L. Dieffenbacher, E. L. Emerson, R. D. Bradley, H. M. Boldt, W. V. Grimes, 
W. I. Thurman. 

Iowa — Drs. — Robertson, N. S. Craig, .Joseph A. Treat, H. Lindner, D. W. 
Jackson, J. B. Galer, W. Painter, .1. AV. Cox. Daniel Sickler (2 years), C. W. 
Duffin. 

Wiscoxsix— Drs. E. J. Ziegler, AV. H. Rowe. J. E. Marsh. 

Kentucky — Drs. H. M. Lowry, J. C. Torpley, W. I. Moore. 

Akk_axsas — Dr. J. T. Foster. 

Georgia — Dr. J. H. McCarty. 

District of CoiXMBiA^Library of Surgeon-General's Office, Dr. D. W. 
Prentiss. 

Colorado — Drs. W. J. Gillett, C. B. Richmond. 

MissOLTii — Dr. W. AV. Moore. 

Indiana — Dr. J. A. Clutten. 

Texas — Dr. A. E. Rogers (3 years). 

Ohio— Dr. W. H. Preston. 

Pennsylyanl\ — Dr. S. A. Suloff. 



4f) The Peoria Medical Monthly. 

Some Things that may Interest Yon. 

A few days ago in a conversation with a leading physician in a 
neighboring city, this remark was made by him : " I have found that 
aconite is a splendid remedy after all." We replied, that we had used it 
for a long time, and were surprised at the manner in which he spoke, 
just as if it was a new thing. " Well," was his answer, " I never had 
satisfactory results until I got hold of the tincture made by the Merrell 
(^"hemical Co." After this he went on to say that he had invariably 
found IMerrell's preparations to be pure and honest, and that he was more 
than satisfied with them, especially the purified ergot, which he had used 
hypodermically in many cases and had never yet seen any bad result< 
follow. His testimony we consider high praise, and yet not too high for 
the standard prej^arations of this house. 

Dr. Herrick's uterine suj^porters have had the unqualified approval 
of several of our friends who have used them. One states that after he 
had tried everj^ pessary and supporter known to him, he succeeded in 
giving his patient perfect relief with one of Dr. Herrick's. 

It will not be disputed that Colburn, Birks & Co., of this city, keep 
the largest assortment of surgical instruments in the state outside of Chi- 
cago, and very many who know, claim that their stock is as large and 
complete as any in Chicago. We do not believe it to be excelled any- 
where, and are certain that physicians visiting this house or correspond- 
ing with it, will get as low })rices and careflil attention as they will get 
from any house in the West. 

Peoria is by considerable odds the second city in the state, and in 
volume of business does not fall far short of any western city except 
(Chicago. 

If but one out of ten of the new remedies introduced by Parke, Da- 
vis & Co. proves to be of lasting value to the profession, that one alone 
should claim and gain for that enterprising firm the gratitude of all con- 
cerned in the treatment of disease. 

The internal revenue paid by Peoria amounts every year to over 
twelve millions of dollars. 

The Murdock Liquid Food is a good thing if we judge from the 
reports which have been made concerning it. We are now trying it in 
several stubborn cases and shall publish the results. 

Celerina is one of the new candidates for professional favor. As a 
nerve tonic it is said to be unexcelled. Certainly the formula which 
accompanies it comprises some of our very best nervines. 

The firm of B. Keith & Co., New York, needs no introduction to our 
readers. Their pharmaceutical preparations have long been considered 
as among the most reliable. See what they say about their methods on 
page 80 of this issue. 

The extract of malt made by the Trommer Co. is steadily grewing 
in favor. The value of malt as a constructive is now conceded by all. 

The im[)rovements now in progress in Peoria involve the expendi- 
ture of over two millions of dollars. 



The Peoria 
MEDICAL MONTHLY. 



Vol. III. JUNE, 1882. No. 2. 



©rigmal (fJommuuifatiottiss. 



Art. I. — Clinical Contributions to Electrical Therapeutics. Paper No. VII- 
Concluded. By Romaine J. Curtiss, M. D., Joliet, 111. 

SKIN DISEASES — CHROMOPHYTOSIS. 

Case 14. — Mr. , aged about 23, on his travels got 

inoculated with the maferies morhi of chromophytosis. 
He had carried the picture about a year when I saw him. 
The disease completely covered the anterior half of the 
trunk, and there were patches of it on his back. He was 
directed to use a solution of chloral, an ointment of zinc, 
and to bathe twice a day with use of green soap, thoroughly 
washing away the loosened cuticle. This treatment was 
of no avail and afterwards chrysophanic acid and mercurial 
preparations were used. Various other medicines were 
prescribed, and he continued medication for about four 
months locally, and I gave him cod's oil and Fowler's solu- 
tion. The disease would clear up in places at times, or its 
nroducts with cuticle be washed off by aid of green soap 
c«j.d the surface of patches look clear for a time, but would 
soon be covered by a fresh plant. During part of this time 
he wore a special covering for the diseased surface, using a 
new one every day, my opinion being that the clothing 
preserved the germs of the disease with obvious results. 



48 The Peoria Medical Monthly. 

I began to use galvanism in this case as a sort of der- 
nier ressort, and because I did not know what else to do. 
The applications were made daily, a large sponge being ap- 
plied to the diseased surface and the positive pole at differ- 
ent places on the healthy skin. The disease began to 
disappear immediately. The skin along the median line 
became healthy first, and extended outwards until the 
disease disappeared. 

HERPES — SHINGLES. 

Case 15. — Mr. , aged 48 years, had complained of 

heart disease (intercostal neuralgia) for several years. Lat- 
terly he had an eruption of herpes zoster, covering the 
greater portion of left chest. He had taken iron, arsensic, 
cod's oil and quinine with some benefit, and was using a 
lotion of cologne, glycerine and lead. 

The continuous galvanic current was used every other 
day in this case for some time, without benefit. I then in- 
terrupted the current, using varieties of tension and num- 
ber of cells, but the disease refused to yield until the faradic 
current was used, which made short work of his shingles, 
greatly to patient's relief, for he was impressed that should 
the disease extend to the right side of his spine his life 
would soon terminate. 

ECZEMA. 

Case 16. — Miss — — , aged 18 years, had eczema, cover- 
ing left side of nose and portion of cheek, of four years' 
duration. She had been through the regular course of 
zinc, arsenic, iron, quinine, cod's oil, etc., etc., and had "tried 
Homoeopathy," which was found wanting. No medicine 
was used in the treatment of this case, but the galvanic 
current effected a cure in four months. The poles were 
applied indifferently, one being over the eruption and the 
other sometimes behind the ear and sometimes on the cer- 
vical spine. After each seance there would be for a few 
hours some swelling and increased redness of the eczema- 
tous skin. 

ACNE. 

Case 17. — Mr. — '—, aged 20 years, had been disfigured 
by acne of the face since his fifteenth year. He had a 



Original Communications. 49 

long history of mortification of spirit, sulphur baths, zinc 
ointment and Fowler's solution. The treatment of galvan- 
ism was continued at irregular intervals for six months. 
Each application had the effect of so reddening the surface 
where the sponge was applied to the face, that the patient 
would take his dose only late in the evening; — a sample of 
pride under great difiiculties. He was cured, however, 
without lotion, ointment or medicine. 

AMAUROSIS. 

Case 18. — R. M., aged 23 years, worked in the rail 
mills, and was subject to extreme degrees of temperature 
during the "heats." He gradually became blind^ — could see 
the largest test type with indistinctness only at a few 
inches. He had naso-pharyngeal catarrh and sequent vom- 
iting, steel scales, and caj^bonaceous matter was always 
present in the nasal and pharyngeal cavities, where they 
could be seen by the laryngoscope. 

The patient was obliged to stop work, and was treated 
for his catarrh by sprays, and his amaurosis by galvanism, 
for six months, when he was discharged cured. The cur- 
rent from five or six cells was generally used, and the po- 
sitive pole applied over the qjq and the other over the 
mastoid. The current was tempered by the rheostat, so 
that during its passage faint flashes could be seen. In this 
case the retina of the eye was anaemic. 

AMEN0RRH(EA. 

Case 19. — Miss , aged 26 years, had been a teacher 

in public schools for eight years. During past two years 
she had suspension of the menstrual function and occasional 
attacks of asthma. She was plethoric; of good appear- 
ance physically and complained of no local pain or other 
sensory disturbance. I suppose, in the light of modern 
pathology, her disease would be called neurasthenia, of 
some set of motor or gland nerves. She declined a pelvic 
examination, and I recommended galvanism for the amen- 
orrhoea. The current was passed from the lumbar region 
through to ovaries. The seances were held twice a week, 
and during the sixth week of treatment the menses were 
restored, which had the effect of stopping the asthma. 



50 The Peoria Medical Monthly. 

lead poisoning. 

Case 20. — Mrs. — — , aged 23, married four years, no 
children; was a fashionable person of most intense personal 
vanity. She was a perfect specimen of neurasthenia; 
the antecedents and sequences of this disease were all 
there. She was even subject to hay fever. She had uter- 
ine disease, and had been subject to the silver treatment 
for a year or two by an eminent gynaecologist of Buffalo. 
She had "wrist drop," which was very noticeable when I 
made my first visit, and I suspected the cause of her ab- 
dominal pains; which suspicion was confirmed by an in- 
quiry in this direction and the exhibition by her husband 
of her large collection of hair washes and cosmetics, all of 
which contained lead. The patient had been bed-ridden 
for several months. Her coi^metics were disposed of; 
iodide of potash was given, and general faradism employed 
daily for a month, when she recovered from her neurasthe- 
nia, and resumed her social standing without the aid of 
lead, 

LUMBAGO. 

Case 21. — Mr. , a carpenter, strained his back by 

working on a cornice and was placed hors de combat by 
pain in his back when he attempted to move. His appear- 
ance and movements were such as are always exhibited by 
the lame back. He came to the office three times and a 
current of sixty cells was passed through the painful part, 
about fifteen minutes each time. The relief was marked 
-at each dose of the remedy and the cure prompt. 

Case 22. — Mr. , aged about 40 years, a rheumatic 

■subject, was brought to my office and carried in groaning 
from pain, which was referred to the lumbar region. This 
case illustrated the exception which proves all rules. I 
applied the galvanic current, with very large quantity, with 
greatly lessened intensity, fully expecting to stop his pain 
and groaning in a few minutes. To my surprise he com- 
plained of an increase of the pain and in a few minutes 
fainted. When he recovered he refused to allow further 
galvanization and would not take medicine. He was taksn 



Original Communications. 51 

home and a physician sent for who gave him morphia, and 
sympathized with him by remarking that "electricity was 
a humbug anyhow" — an opinion to which the patient gave 
his free assent, and I suppose they are both of the same 
opinion still, and that each of them knows as much about 
it as both, and both of them as much as either. 

rheumatism. 

Case 23. — Mr. , aged about 30 years, a laborer, na- 
tive of England, had muscular rheumatism of the right 
leg. The muscles were tender, swollen and paretic, and 
he went and came on crutches. There was no evidence of 
venereal disease. The patient had a gouty ancestry and 
the exciting cause of his own disease was working in a wet 
ditch. He had suffered from this disorder for several 
months, had taken several medicines and received some 
benefit from iodide and colchicum. He was sent to me by 
a physician who was somewhat undecided about the hum- 
bug of electricity and was disposed to investigate. The 
patient's foot and leg and the negative pole were put into 
a vessel of warm water, the positive pole being applied to 
the leg higher up. This treatment was continued daily for 
two weeks when patient was discharged cured. 

INDURATIONS. 

Case 24. — Mr. , aged about 60 years, had acute 

rheumatism which lasted two months. He was treated by 
salicylate of soda, which failed, as he could not take it 
without insanity, and he was brought through by the alka- 
line treatment. On subsidence of the acute symptoms the 
tendons of various muscles in upper and lower extremities 
were subject to indurations, which showed no disposition 
to absorb. He was given iodide and colchicum without 
much benefit, the enlargement Of the hamstring tendons 
and tendons of ankle joints and wrists being thick and pain- 
ful. He remained without much improvement for two 
months, when he was brought daily to the office for gal- 
vanic treatment. The different indurations were treated 
separately by passing the galvanic current through them. 
The treatment was continued daily and every third day for 



52 The Peoria Medical Monthly. 

three months, when the indurations of the tendons were 
absorbed and the normal functions restored. 

Case 25. — Mr. , aged 37 years, a merchant, sprained 

his ankle severely, which injury was followed by an indu- 
ration of the tendo Achilles. The tendon in lower half of 
its length was more than double its natural thickness. 
This deformity was treated every other day for a month 
with the negative pole attached to a roller electrode, thus 
combining the electrolytic effects with massage, a very 
convenient and efficient method. The tendon was restored 
to its morphological and physiological integrity. 

N^VI MATERNI. 

Case 26. — Miss , aged 12, had a port wine mark on 

her left cheek about the size of a dime. The natural 
beauty of the anatomical deformity was somewhat deteri- 
orated by several applications of some sort of caustic, 
which had however not removed it. Three fine needles 
were inserted through the ngevus, carrying the negative 
pole, and the positive was placed near by on the sound 
skin. The current from the cells was used about five min- 
utes. In a week the operation was repeated and the 
naevus disappeared. 

Case 27. — Miss , aged 16, had a prominent, raised, 

purple ngevus on the left cheek; a physician had attempted 
its removal with a faradic machine and afterwards applied 
caustic, and then suggested cutting it out. In this case 
four electrolytic applications of galvanism were used,, 
which removed the mark. 

Case 28. — Mrs. , by some slip of the embryonic 

tissues had a spot on her left upper lip about half an inch 
in diameter, from which sprang a vigorous growth of hair. 
I undertook to destroy the hair follicles in this case, and 
succeeded after the following method: A small needle 
(negative pole) was pushed into the follicle beside the hair 
and held in position about five minutes, the lady holding 
the other electrode in her hand. Five or six hairs were 
thus abused at each seance until the whole crop was re- 
moved. This is' an operation which is tedious and very 



Original Communications. 53; 

useless unless there is considerable beauty behind the un- 
natural growth. It is however a very satisfactory opera- 
tion for the patient. 

LOCAL ATROPHY. 

Case 29. — Mr. , received an injury to the shoulder 

in a railroad accident. There was nothing of dislocation 
or fracture, but the injury was followed by atrophy of the 
deltoid muscle. There was no antecedent paralysis; but. 
the muscle, what was left of it, would contract by volitional 
stimulus, though there was not force enough to raise the 
arm from the body to a level with the shoulder. The far- 
adic current was used in this case, with the roller electrode 
for three months, the applications being made two or three 
times a week, when the muscle was restored in form and 
function. 

Case 30. — Mr. , about a year before I saw* him, was 

thrown from his -horse, striking on the back of his right 
shoulder. The arm was useless for several months from 
pain and paresis. On examination the spine of the scapula 
was his most prominent morphological feature, by reason 
of the atrophy of the muscles above and below. Elec- 
tricity, faradic and interrupted galvanic, with massage, 
were used for this deformity for a year with the result of 
making restoration, which, though not complete, was ser- 
viceable. 

Case 31. — Mr. — , aged 23 years, had typhoid fever, 
the duration of which was six weeks. During conva- 
lescence he over-fed and was relapsed for nearly two 
months. He finally recovered from this illness, and rapidly 
gained his average weight of 170 pounds; but three months 
afterwards his gait was ataxic, for the reason that he had 
lost sensation of his legs and feet. There were no pains in 
legs, nor other evidence of tabes, except diminished sensa- 
tion. The faradic current was used in this case and fully 
restored the sensation of legs in a month's time. The ap- 
plications were made daily by placing the feet in a bath 
containing one pole, while the other was applied on the 
extremities above — to the spine or held in the hands. 



54 The Peoria Medical Monthly. 

Akt. 1 1. —Herpes Zoster, vel Zona, vel Ignis Sacer (Holy Fire), Shingles. 

Read before the Peoria City Medical Association. By Roijeht Roskoten, 
M. D., Peoria, 111. 

Among the few acute species of that very large class, 
""herpes," zoster is one of the most interesting. It is an 
acute, inflammatory disorder, characterized l^y the appear- 
ance of one or more groups of vesicles upon an inflamed 
base, and attended by neuralgic pain. The course of the 
disease may be divided into three different stages. The 
symptoms of the first stage, which may be termed the pro- 
dromic, are those of a severe form of neuralgia, corres- 
ponding with the seat of the impending eruption. When 
zoster aff'ects the trunk- — its most common seat — gastric 
and intestinal disturbances, similar to those noticed in 
erysipelas, are common. This stage varies from a few 
hours to several days, even weeks. The second or eruptive 
stage is ushered in by an intense burning pain, soon fol- 
lowed by the appearance of red spots, which either remain 
discrete, or run together, forming a belt from one to two 
inches wide, encircling one-half of the body. Rising from 
these spots at irregular intervals, there appear one or more 
groups of well-developed vesicles, filled with a transparent 
fluid, and varying from the size of a pin-head to that of a 
split pea. Occasionally adjoining vesicles coalesce, and 
small bullae are formed. There remains a distinct areola 
of redness around each vesicle. When the eruption is thus 
fully developed, the severity of the neuralgic pain, as a 
rule, is greatly diminished. The walls of the vesicles are 
firm and have no tendency to rupture, hence desiccation; 
preceded by opacity of their contents is the rule. 

Several groups of vesicles may appear simultaneously 
or in successive crops, and thus this stage be prolonged for 
weeks or even months. 

The advent of the third stage is heralded by a fading 
•of the red areolae; the vesicles shrivel up and a thin, yel- 
lowish-brown crust remains, which drops off in the third 
week leaving a red surface. When the case was very 
severe, permanent scars will remain. The neuralgia gen- 
erally ceases at this time, but may be prolonged for several 



Original Communications. 55 

weeks. In other cases it returns after the eruption has en- 
tirely vanished. 

The great disproportion between the pain and the ap- 
parently insignificant eruption, as well as its neuralgic 
character aad course, point positively to the seat of the 
affection as being in the nerves. This supposition is borne 
out by the facts recently elicited by von Baerensprung, who 
repeatedly after death found the nerve-trunk diseased. 

Herpes circinatus and herpes iris can not well be con- 
founded with zoster, as their vesicles are arranged in a cir- 
cular form, and their seat, unlike zoster, is almost exclus- 
ively limited to the hands and feet, while the eruption is 
not attended with neuralgic pain. 

Zoster has some resemblance to erysipelas bullosus 
and to pemphigus. But in erysipelas the cutaneous swell- 
ing is more uniform and covers a greater area, while the 
exudation appears in the shape of blebs, without a separate 
halo, the concomitant fever is higher and the pain more of 
an inflammatory than of a neuralgic character. In zoster 
the vesicles appear in groups surrounded by a halo. It is 
true, during the progress of the eruption and shortly be- 
fore the approaching desiccation, the halo may spread and 
the vesicles become confluent, forming large blisters, but 
they are always surrounded by a distinctly marked halo. 
Pemphigus presents either a solitary bulla, or a number of 
them scattered over the body independently of the course 
of any nerve, and is marked by the absence of neuralgia. 
Eczema occasionally resembles herpes, but can be easily 
distinguished from it by the intense itching, the smaller 
size and early rupture of the vesicles, by the more abund- 
ant exudation and larger size of the crusts. With varicella 
zoster has been confounded in a few cases. 

Different names are attached to this species of herpes, 
indicating the locality in which it appears. Thus we have: 

1. Zoster pectoralis; occurs most frequently in the 
lower pectoral region on one side, between the fourth and 
seventh ribs, extending from the spinal column behind to 
the middle of the sternum in front. Before the eruption 
comes out pleuritic pain and palpitation of the heart are 
not uncommon. 



56 The Peoria Medical Monthly. 

2. Zoster abdominalis is the form from which the 
name cingulum or shingles is derived. It is frequently at- 
tended by colic and gastro-intestinal irritation. I have 
observed two cases where it appeared alternately with 
dysentery. It was in this way: after the dysentery had 
lasted a few days the eruption took place and the tenesmus, 
etc., disappeared; but as soon as the vesicles became dry, 
the dysentery recommenced with renewed vehemence, fol- 
lowed by a new crop of zoster. This process continued 
until the whole belt was formed, when finally the dysen- 
tery terminated. 

3. Of zoster cervicalis there are several varieties. 
Herpes in the one affection is confined to the upper part, of 
the neck, while in the other it extends from its lower part 
down the arm as far as, or even beyond the elbow, usually 
on the flexor surface, called herpes cervico-brachialis. 

4. Herpes axillaris extends from the region of the 
nipple upwards to the tip of the shoulder. 

5. Herpes facialis may occur in any part of the face; 
the most important being that extending along the supra- 
orbital nerve and upon the side of the nose. It is of special 
danger to vision, sight being occasionally totally destroyed. 

Furthermore, I could mention herpes of the scalp, 
which is of rare occurrence. 

Among the forms of zoster in the lower extremities, 
those following the course of the anterior crural nerve and 
its branches, and of the sciatic nerves, are the most import- 
ant as well as the most frequent. Herpes below the knee 
is very rare. 

Zoster is not contagious, but under the same circum- 
stances which favor an epidemic of erysipelas, i. e., un- 
known cosmic influences, many cases of herpes have been 
noticed. 

The disease is liable to occur but once in the same 
individual, unlike the other forms of herpes, of which one 
attack predisposes to another. 

The treatment is simply symptomatic. Excessive pain 
calls for anodynes, /. /., belladonna, cannabis indica, mor- 
phium or opium internally or hypodermically near the 
seat of the pain. Electricity, the constant current, is an 



Original Communications. 57 

excellent palliative. If the neuralgia is of an intermittent 
character, or if it remains severe even after the eruption is 
out, antiperiodics are called for. Morphia may be advan- 
tageously combined with quinia. Camphorated oil or black 
wash are useful soothing applications. It should be our 
aim to prevent the rupture of the vesicles. This may be 
done by sprinkling them thickly with flour, lycopodium, or 
any good dusting powder, and by covering them with cotton- 
batting secured by bandages. The cauterization of the 
zoster with nitrate of silver has been highly recommended, 
but should be limited to the later stage. 



Art. III. — New Uses of Old Remedies, A Report to the Central Illinois 
Medical Society. By O. P. Paulding, Arrowsmith, McLean County, 111. 

Mr. Preside?it and Member's of the Central Illinois Medical 

Society : 

I must beg your indulgence for not complying with 
the request of the committee on programme, by writing 
an article on new remedies, but ask you to listen for a 
few moments to a short dissertation on the new uses to 
which some of the older ones are ax3plied. I am compelled 
to make this change because of my inability to find any 
one in this part of our vineyard who has tried them. 

Some of my medical journals contain articles on some 
of the new remedies, but they are mostly from the fertile 
pen of that sage of Tennessee, who is correspondent to 
some thirty-five medical journals. And when we read that 
he has treated from three to ten patients successfully with 
such and such a drug in a few months, cases that a country 
practitioner probably does not see one in years, we must 
conclude that the small village of Pulaski is a made up 
town for a doctor — a town better than a hospital for clin- 
ical study — or else the cases are made up. 

BICHROMATE OF POTASSIUM IN SYPHILIS. 

Dr. J. Edmund Guntz makes some novel announce- 
ments regarding the treatment of syphilis. If true, they 
are of the highest importance. He claims to be able "not 
only to do away with mercury in syphilis, but in a large 
proportion of cases to abort the disease." In 1869 he advo- 



58 . The Peoria Medical Monthly. 

cated the use of bichromate of potassium as being a useful 
drug in treating syphilis. He gave the drug pure at first, 
but it acted slowly and was apt to disturb the stomach. 
Then he combined it with nitrate of potassium, giving a 
pill of 1-15 grain each, three times a day. These produced 
remarkably favorable results. Yet the action was slow, 
and when a prompt one was needed, as in malignant cases, 
this remedy would not meet the expectations. Finally 
mixing it with carbonic acid water, he found that much 
larger doses could be taken in this form, and that a pro- 
founder impression on the system could thus be made. A 
maximum dose is 8^ grain* of bichromate of potassium 
daily, in 20 ounces of carbonic acid water divided into five 
doses; larger amounts provoked vomiting. He calls this 
mixture chromwater, and says that it can be given daily 
for weeks and months in all forms of syphilis without det- 
riment to health. 

The following are his statistics: In one and one-quar- 
ter years he treated 194 cases of chancre; of these he 
selects 85 to remove any source of error; in 14 of the 85- 
the sores were cauterized, the remainder were treated with 
nothing but chromwater, and in 47 of them constitutional 
syphilis failed to appear. In order to avoid every possible 
chance of mistake the author excludes 10 of this 47. Even 
then there were left 37, or over half, who when given chrom- 
water alone, developed no after symptoms. Still more 
favorable results took place with the 14 cases that were 
cauterized. Of these only two developed symptoms of con- 
stitutional syphilis. His statistics thus show that of the 
85 cases selected 49 showed no constitutional symptoms. 
Dr. Guntz has used bichromate of potassium exclusively in 
the treatment of syphilis for years, and has given it in 
more than a thousand cases. He thinks the day of mer- 
cury is over. Dr. Guntz has also used his chromwater with 
the best results in diphtheria. He says that the drug acts 
by reason of its powerful oxidizing properties, and thinks 
that in chromium we have an agent that is inimical to the 
syphilitic poison, which does not harm the system itself,, 
but benefits it. 



, Original Communications. 59 

CODIA. 

This alkaloid of opium has been taking a benefit of 
late. The following are a few of the comparative relation- 
ships of codia and morphia physiologically: 

1. Codia is a greater cardiac stimulant. 

2. Is a more powerful diffusable stimulant. 

3. It does not check the secretions to such an extent 
as morphia; indicated when it is desired to avoid locking 
up the secretions, bowels, liver, expectorations, etc. 

4. It is greatly less dangerous than morphia, no lethal 
dose having been recorded; therefore, better for infants. 

5. It is never followed by intense nausea. 

6. There is no danger of inducing the opium habit. 
Dose — Sulphate codia, generally used, double that of 

morphia. 

NITRO-GLYCERINE 

Is seeking favor as an anti-neuralgic; is also found useful 
in tetanus, hydrophobia, seasickness and chloroform pois- 
oning. In angina pectoris its effects are more marked. 

SULPHATE OF ZINC. 

For the last two years we have been using sulphate of 
zinc in chronic malaria, with marked success. We have 
also administered zinc in first attacks of chills, with good 
results. The usual mode of treatment was to give a brisk 
cathartic, not forgetting to add calomel; then give 3 grains 
every 3 or 4 hours, without stopping for the fever. Usually 
they have one slight chill, possibly two, but never the third, 
if the drug was ever to do any good. We have had equally 
good results from zinc as from cinchonia in chronic cases. 
Zinc administered on the same plan to persons suffering 
from neuralgia, has given good results. The stomach tol- 
erates the drug very well; occasionally there is some 
nausea, but generally it allays the irritability of the 
stomach that usually accompanies most cases of neuralgia 
and chills. Children cry for it,, for it can be put up in a 
more palatable form than most of our remedies for such 
ailments. 

We have tried the iodine and iron treatment for chills, 
but have to condemn it on account of its causing nausea 



60 The Peoria Medical Monthly. 

iu most of our cases. Usual plan of administering it was 
10 drops of each, largely diluted, 3 times a day, after meals. 

Tincture guaicum has become quite a prominent drug 
in the treatment of nearly all kinds of sore throat. In 
those of the follicular variety it exerts its most marked 
influence. In follicular transititis it is a specific. 

We use it in all coughs that are due to irritation of the 
fauces, even in the cough of phthisis. In this class of cases 
it is used as a gargle or in the form of a spray. Usual dose 
in tonsilitis 10 drops every three hours. As a spray or 
gargle 2 to 5 drops at a time, using glycerine as a vehicle. 

STRAMONIUM. 

Writers class stramonia with belladonna, both in its 
physiological and pathological action, especially their alka- 
loids — datura and atropia — only datura does not manifest 
itself in so marked a degree as atropia, but has more marked 
action on the secretions. 

Stramonia is classed by Dr. Headland as a neurotic, 
Div. II., Order III., deliriants. Deliriants have a slight 
stimulant effect, hence a greater secondary one. 

The medicines of this class tend to diminish the quan- 
tity of nervous force and are thus like sedatives. 

Stramonia when given in large doses acts as a deliriant. 
When given in small doses it exerts a sedative action on 
the nervous system, more especially those nerves that are 
distributed to the womb and its appendages — next in order 
to the nerves of the bladder and rectum, then the eye and 
skin. 

The use of the drug to which we wish to call your at- 
tention, is in cases of threatened abortion. Its mode of 
action in these cases is as a sedative to the nerves that sup- 
ply the womb, quieting the hyperasthenia that is ever pres- 
ent in these cases, thus stopping the spasms of pain, and 
by giving rest relieve the engorgement. We rely on stra- 
monia in all our cases of threatened abortion. The follow- 
ing are a few of the cases in which it has been given: 

Case 1. — Mrs. A , aged 22, mother of one child, had 

aborted twice since birth of first child. P'irst at three 
months, second at five months. She had to remain very 



Oeiginal Communications. 61 

quiet at what would have been her menstrual period or 
would have aborted before. She came to me with the above 
history, in second month of pregnancy. She was given 
some stramonia seed, with directions to eat from 4 to 6 
every time she felt any pain, and to take to her bed for an 
hour or two, at least till the pain quieted, she to repeat the 
dose every half hour till relieved. She followed my direc- 
tions for seven weeks, after which no more pains were felt 
till those at full term, when a healthy child w^as born. 

Case 2. — Mrs. G , aged 25, never had given birth to 

a full term child; had aborted twice — once at one month, 
second at seven months. She was given the same remedy^ 
with the same directions. She had to use the seed occa- 
sionally till the eighth month, when the pains ceased to 
trouble her, then went on to full term. 

Case 3. — Mrs. M , aged IS, newly married, felt pains 

at first month. Put under the same treatment. Felt pains 
occasionally till the sixth month. From that time till full 
term she suffered no pain. 

Case 4.- — Mrs. E , aged 27, same as above. 

Case 5.— Mrs. B , aged 31. This woman came to 

me with a history of thirteen abortions. Has one child 
living, born at seven months. The others were lost from 
the second to the seventh month of gestation — nearly all 
were lost between the third and fourth months, next great- 
est number at about six months. At the time I saw her 
she was in the third month. The usual plan of treatment 
was pursued in this case as had been in the others. All 
went well till she entered the ninth month — having had 
Ibut little trouble to control the pains (which had come on 
occasionally) with the seeds and rest. She became care- 
less and went to working too hard — lifting, running up and 
down stairs, etc. This exertion caused pains to come on 
that nothing but delivery would stop. By the time I ar- 
rived at the house the child was born. No doubt had she 
cared for herself she would have given birth to a full term 
child. 

We might mention several other cases, but no doubt 
these will suffice. So far we have only failed in two cases. 



62 The Peoria Medical Monthly. 

In none of the cases in which this remedy has been used 
has there been any bad effects. The womb responds well 
to the call of nature to expel the child when time has ar- 
rived for its doing so, nor did any relax afterwards. 

These seeds are also used in the relief of after-pains, 
when they are so severe as to need any attention, and so 
far in these cases no bad effects have been observed. They 
will be found useful in allaying the pain of ovaritis, and 
at times, in special cases, to relieve the pains of menstru- 
ation. 

In the class of cases that stramonia has been used, it 
has vast advantages over opium, for it does not constipate 
the bowels nor derange the secretions, unless it is to in- 
crease them, which is usually an advantage. 

In the administration of the drug the seeds were used. 
Their action will be found much more satisfactory than the 
tincture or fluid extract or the alkaloid, possibly owing to 
some extractive matter not found in the preparations. The 
usual dose is from four to ten seeds, to be chewed up fine 
and swallowed every half, one, two, three or more hours 
apart. We admit that the dose is quite small, but yet it is 
no decimal dilution. 



Art. IV. — Past and Present: Then and Now. The President's Annual Ad- 
dress. Delivered before the Illinois State Medical Society at Quincy, 111., 
May 16, 1882. By Robert Boal, M. D., Peoria, 111. 

During a professional life of over half a century, I have 
occupied no position which has afforded me greater pleasure 
than the one with which you have honored me to-day. 

To preside over an association embracing so large a 
share of the ability, reputation and intelligence of the 
medical profession of the state, is at all times an honor to 
be highly prized, but to me it has an added value from hav- 
ing witnessed its birth and watched its struggles through 
infancy and youth up to manhood. 

A generation of human life has almost passed away 
since a few earnest and active members of the profession, 
twelve in number, in the library room of the old capitol in 
Springfield, organized our present association, the Illinois 



Original Communications. 63 

State Medical Society. From this small beginning it has 
grown to its present proportions, and the twelve has been 
multiplied into hundreds of active and intelligent members. 
To • one who has lived through, and witnessed it, the 
marvelous progress that has been made during the past 
fifty years in population, wealth, in science and the arts— 
in liberty, law and human rights, in a degree never before 
known in history, is a subject of unceasing interest and 
admiration. I trust I may be pardoned, therefore, if I de- 
part from the custom of addressing you upon subjects 
usually selected for such occasions, and for the short time 
I occupy your attention contrast the past with the present, 
the then and now. It is oftentimes well to look back at 
the past, and pause in the race of human life and measure 
the path over which we have trod, for the experience of 
the past, with its joys and griefs, its successes and failures, 
if wisely used, may teach us lessons of duty for the future. 
History contains no record of a people whose progress has 
been so rapid and marvelous as our own. What wonderful 
changes a half century has wrought ! Then our popula- 
tion was a mere handful, now it numbers over fifty mil- 
lions. Then our resources were undeveloped, now they are 
vast and varied. Then our territory was comparatively 
small, now it extends from ocean to ocean. Then our own 
great state was sparsely populated, now it is the fourth in 
population, and among the first in enterprise, intelligence 
and industry. Then the beautiful city in which we are 
assembled, as well as the one from which I come, were 
mere hamlets; now they number their thousands of indus- 
trious and enterprising men and virtuous, refined and cul- 
tivated women. Then the great city which sits so grandly 
at the foot of Lake Michigan was a quagmire, now it has 
become the glory and pride of our state, the wonder of the 
age, and the admiration of the world. Then our means of 
communication and travel" were by stage coach, canal and 
steamboat, and were slow and often interrupted; now every 
part of the country, however remote, is bound together by 
bands of iron and steel, and the ponderous tread of the 
locomotive, as it moves with the rapidity of the weaver's 
shuttle, is heard over every portion of our widespread land, 



64 The Peoria Medical Monthly. 

almost annihilating time and distance, making us one 
people, with one country and one great future. Then in- 
telligence of events, however important, reached us by mail 
or messenger long after they transpired; now for this pur- 
pose we have brought into marvelous use the subtle and 
mysterious electric current. Then its powers and capabili- 
ties were comparatively unknown, now we know the agen- 
cies that can control and develop it, and have since 
the first message sent by Miss Ellsworth, **What hath God 
wrought," caused it to encircle the globe, and made it the 
"swift messenger of mortal thought and the obedient in- 
strument of human will." Then the interchange of thoughts 
was made either by letter or in person, now from our offices, 
our firesides and places of business we can converse with 
friends, prescribe for patients, transact business, send and 
receive messages of congratulation or condolence, and hear 
sermons, lectures or speeches miles away. But while all 
this marvelous progress and change excites our wonder 
and admiration, it is to the contrast between then and now 
in our own profession to which I ask your attention. 

Fifty years ago the agencies and facilities for ob- 
taining a professional education were few and far 
between. Then but two medical colleges were in 
existence west of the Alleghany Mountains — the Medi- 
cal DeiDartment of Transylvania University at Lexing- 
ton, Kentucky, and the Medical College of Ohio, founded 
by that giant in the profession, the late Dr. Daniel 
Drake ; now towns of fifteen or twenty thousand in- 
habitants boast of at least one medical college. Then a 
faculty, composed of five or six professors, with an occa- 
sional adjunct, was deemed a large and imposing one, in 
numbers at least, whatever else might be said as to its 
qualifications in other respects; now in every medical 
school, however small or obscure, a long list of professors 
of every conceivable subject in the profession is published 
and the doctrine of the division of labor has been carried 
out to an extent hitherto unknown. 

If, half a century ago, our educational facilities were 
meagre and inadequate, have we not now gone to the other 
extreme and multiplied our colleges until the supply is 



Original Communications. 65 

greater than the demand ? Has not the competition among 
these numerous institutions lowered the standard of pro- 
fessional qualifications hj holding out inducements to stu- 
dents to enter them, without the necessary preliminary 
education, and narrowing the requirements for graduation 
to such a degree, as to send forth illiterate and incompe- 
tent men, thereby imposing upon the public and bringing 
a reproach upon the profession ? If we are to be afflicted 
with this swarm of medical colleges, permit me to suggest 
whether it would not be wise to utilize them, and circum- 
scribe their evils by placing them in the same relation to 
the established and reputable metropolitan schools that in 
our educational system the high school and academy sus- 
tains to our colleges and universities ? If we could deprive 
the majority of these institutions of the power to confer 
degrees, and let them fit the student for entering medical 
colleges located in the great centers of population, where 
only clinical instruction and facilities for dissection can be 
obtained, as an academic course fits for entrance to a liter- 
ary college, they might then become useful adjuncts in 
securing for those who desire to enter the profession the 
best and highest qualifications, and to the public the ser- 
vices of competent and educated medical men. Free trade 
as a doctrine of political economy, and competition to 
regulate transactions in the commercial world, may be all 
right in their way, but neither is applicable to medical 
education. The remedy (if any) rests mainly with the 
profession. Let it discountenance as far as practicable the 
establishment of colleges where they are not needed. Let 
it in the name of humanity demand and endeavor to pro- 
cure such regulations and enactments as will deprive these 
small, obscure and numerous institutions of the power of 
conferring degrees in medicine and accrediting the illiter- 
ate and incompetent to the community. The people sel- 
dom discriminate between those who are called doctors. 
A doctor with them is a doctor, no matter where or how 
he has been educated, or whether he has been educated at 
all; and the superficial, ignorant and cheeky possessor of a 
diploma, often bought outright, is as likely to share the 
confidence and patronage of the community as the most 



66 The Peoria Medical Monthly. 

competent and meritorious physician. How or when (if 
ever) this needed reform can be effected it is hard to say. 
It is to be hoped that the progress of the age and its re- 
quirements will wake up the public to the fact that for its 
protection and safety, not that of the doctors, such reform 
is needed. 

Then the practice of medicine in all its depart- 
ments was pursued by the same individual, now we have 
specialists for every branch of the science and art of medi- 
cine. Then every practitioner was physician, surgeon, 
obstetrician, gynecologist, opthalmologist and dentist; now 
all these are special subjects of study and practice, and as 
a result wonderful advances have been made in these 
branches of the profession, and life has been rendered more 
tolerable and happy, through the skill thus acquired. Then 
the treatment of disease was generally heroic — calomel, 
antimony and venesection were the common and indis- 
l^ensible remedies; that they were useful and potent rem- 
edial agents, and in their day did much good, is true, but 
it is equally true that their lavish and indiscriminate em- 
ployment did great harm. Where is the physician of the 
present day who would have the temerity to repeatedly 
bleed a patient '*ad deliquum animi," and keep him nau- 
seated for days upon tartar emetic to cut short a case of 
pneumonia or pleuritis ? Where is one to be found who 
would administer scruple or half drachm doses of calomel, 
or a correspondingly large amount of antimony, every three 
or four hours ? 

Now, we have perhaps a better knowledge of disease 
and a better practice founded upon it, yet it may be ques- 
tioned whether we have not lost much that is valuable by 
swinging to the other extreme; — becoming too largely ex- 
pectant in our treatment of disease, and abandoning the 
use of remedies, which if properly directed, are callable of 
accomplishing so much good. Who performs venesection 
now? Some of the older members of the profession may 
occasionally practice it, for it is not easy to forget the les- 
sons of their youth. To most of the younger it is a relic 
of the past and lives only in history. It has been aptly 
characterized as one of the ''lost arts" by a distinguished 



Original Communications. 67 

■eastern professor, when a few years ago he so ably and 
forcibly urged its restoration. Then every practitioner 
was his own druggist and pharmacist. He made his own 
pills and tinctures, compounded all his medicines, and gen- 
erally carried all he required, as with saddle bags on his 
arm, astride his horse he wended his way from house to 
house, administering to the sick and ailing, always wel- 
come, and often regarded as an angel of mercy, although 
his homely garb and rough appearance looked anything 
but angelic. The life of the doctor of that day was one of 
peril, toil and privation. Now it is one of comparative 
safety, ease and comfort. Then the country was thinly 
settled and his rides were long and solitary; now it is pop- 
ulous, the doctor's excursions are short, and he seldom 
lacks companionship. Then his patients were scattered 
over a wide extent of territory, and his travel was mostly 
performed on horseback, and its extent and duration was 
measured only by the power of endurance of himself and 
his horse; now the area over which even the country phy- 
sician travels is limited to a few square miles, and he jogs 
along in his buggy and carriage without discomfort or 
fatigue. Then often on his errands of mercy, he swam his 
horse over swollen streams,. or made a long detour to ena- 
ble him to cross or avoid the still more treacherous sloughs, 
sometimes following for miles a trail or path which he was 
liable to lose at any moment, with no living thing around 
him save the sneaking and cowardly prairie wolf or a herd 
of startled deer; now the swollen streams are bridged, the 
sloughs have been drained, and the broad highway has suc- 
ceeded the trail and bridle i)ath. Then, often whole days 
and nights were spent in the saddle without rest, except a 
few snatches of sleep, sometimes taken on horseback, 
sometimes in the lonely cabin of the settler; now, in the 
abundance of the material with which the profession is 
supplied, no such sacrifice of ease and comfort is required. 
Then, at the call of sickness or pain, he promptly responded, 
whether in the sunshine or the storm, or in summer's heat 
or winter's cold, traversing in his long and dreary journey 
great stretches of prairie, blackened by the annual fires 
which swept over it, his vision resting upon nothing save 



68 The Peoria Medical Monthly. 

the black and cheerless plain spread out before him. The 
country was new, the doctors young and few in number, 
and no demand for services could be refused upon any pre- 
text, save that of absolute inability to mount a horse. 
Every emergency, however grave, he was obliged generally 
to meet alone and unaided, for it was seldom assistance 
could be procured without too great an expenditure of time 
and money. Necessity made him self-reliant and coura- 
geous. Now, cultivated fields, neat and comfortable farm 
houses, have taken the place of the burnt prairie; doctors 
are plenty, and many of them are no longer young. Then 
the doctor was poor in purse, for his services were often paid 
for in promises, and seldom in money. (Greenbacks were 
unknown, but "wild cat" was plenty and of little value, 
and the fees were small. The best and most reliable circu- 
lating medium was the products of the country, called by 
the people "truck,'' and with this the doctor was most gen- 
erally paid. Now, while few physicians are rich, nearly 
all make a comfortable living; their services command 
higher prices, and when they are paid for them (which is 
not always the case) it is' in money good everywhere. 

Then, the dependence upon each other, and the kindly 
life of a new country gave the doctor a strong hold on the 
affections of those among whom he lived and labored. 
They loved him while living and mourned for him when 
dead. He did not know as much then as we do now, and 
as we look back we are sometimes inclined to wonder at 
his ignorance, and yet some of them were scholarly and 
educated men, and perhaps knew some things of which we 
are ignorant, and which it would be profitable to learn. 

What was required for the outfit of a physician of that 
day and his mode of practice is well illustrated by a story 
told by one of the early presidents of this society — the late 
Dr. Rouse. On his arrival in the then small village of 
Peoria, he was warmly welcomed by the only physician 
there. He observed that the resident doctor had a large 
pair of saddle bags stuffed tolerably full; his curiosity was 
excited to know the contents, and upon asking the doctor 
what they contained, he readily opened them and disclosed 
an old spring lancet, three or four pounds of epsom salts, 



Original Communications. 6&' 

a pound or more of calomel, a similar quantity of nitrate 
of potash, and from one quarter to a half pound of tartar 
emetic. As Dr. Rouse was a stranger and was supposed to- 
be unacquainted with the practice in a new country, he 
kindly undertook to instruct him. He informed him that 
sometimes when called to see a patient, if he was plethoric,, 
he bled him and gave a large dose of calomel, followed by 
epsom salts. At other times on first seeing the case, if the 
tongue was coated and nausea was ijresent, he gave an 
emetic of tartrate of antimony, followed in due time by 
the calomel and salts. If the stomach and bowels had 
been thoroughly evacuated, he then gave nitrate of potask 
and antimony in small and repeated doses, interspersing 
between them moderate doses of calomel. Then turning 
to his listener he said in the most serious manner, "so you 
perceive, doctor, it is necessary to vary our practice in this 
new country." 

Nor is this an overdrawn picture. The practice in that 
day after venesection was premised, consisted mainly in 
the administration of calomel and jalap in a large dose 
when first called to a case, and then continuing the use of 
calomel alone in small and repeated doses, supplemented 
by nitrate of potash and James' powder or tartrate of an- 
timony as a febrifuge. As a result ptyalism was the rule, 
not the exception. Many a doctor of that day labored 
under the delusion that when his patient's salivary glands 
were swollen, his mouth sore and running a stream, the 
disease was subdued and convalescence follow. So deeply 
rooted was this belief in the minds of most of the practition- 
ers of that day, that the death of a patient treated to a 
profuse salivation was a mystery they could not fathom. 
The only solution ever given, was that the mercury had 
acted locally, and thus failed to impress the system; conse- 
quently the patient died. Quinine was sparingly used. 
The people had a prejudice against it, and its remedial 
powers, as we now know them were little understood. The 
recurrence of paroxysms and exacerbations in febrile affec- 
tions, their periodical return, and means of prevention was 
seldom taken into account, with a few exceptions, by a 
majority of the practitioners of that time. The early 



70 The Peoria Medical Monthly. 

practice of medicine, especially of our own state, which 
was then the West, reminds one of the epigram of a cen- 
tury or more ago, upon Dr. Isaac Lettsom, who is made to 
say of his patients: 

I physics, bleeds and sweats 'em, 
And if they die, I Leltsom. 

Now instead of the large and nauseous doses, clumsy 
pharmacy and crude substances of that day, we have their 
active principles, and our pills, extracts and various other 
preparations are so elegant in form and disguised in taste 
as to be acceptable to the most fastidious stomach. Then 
none of the different schools of medicine so-called were in 
existence. The disciple of Hahnemann, and the dispenser 
of infinitesimals was unknown, and the eclectic was a 
monad. The only school, if it deserves the name, was the 
one founded by Samuel Thompson, a shrewd but ignorant 
and illiterate man. His followers called themselves Thomp- 
sonian — sometimes botanic physicians, but the people with 
a keen appreciation of the fitness of things, dubbed them 
steam doctors. His theory of the origin of disease was 
very simple and his practice corresponded with it remark- 
ably well. As Hahnemann referred the origin of all diseases 
to one cause — itch, so Thompson insisted they all arose 
from what he called "canker,'' though what he meant by 
the term neither he nor any of his followers could tell. 
Their efforts, however, were directed to the destruction or 
expulsion from the system of this imaginary morbific agent. 
In order to destroy and drive this demon out of the body, 
he was vigorously attacked internally by lobelia, capsicum 
or the favorite No. 6, a tincture of capsicum, myrrh, etc., 
and externally by steam or vapor generated by means of 
water thrown upon hot stones, or boiled ears of corn ap- 
plied to the body until profuse sweating was induced; hence 
they obtained the name of ''steam doctors." A portion of 
their stock-in-trade consisted in denunciation of the " Min- 
eral and Calomy Doctors,'' and truth compels the admission 
that it was not always undeserved. This was the germ 
from which the self-styled eclectics grew, matured and 
blossomed. * 



Oeiginal Communications. 71 

Then with the exception of some of the Atlan- 
tic states, we had few local and no state societies; now 
every state in the union, without probably an exception, 
has its society, numbering amoug its members the best 
elements of the profession, all engaged in earnest endeavor 
to advance its interests and increase its usefulness. But 
notwithstanding these praiseworthy efforts on the part of 
the state societies, many of the best minds in the profes- 
sion question whether, as they are ordinarily conducted, 
they are as useful as they might be made. It is thought 
by many 'that the time of the societies is too much taken 
up with voluminous reports from committees, and the read- 
ing of papers whose length would make a good monograph 
upon the subjects of which they treat; that instead of short 
and condensed papers, giving the practical experience and 
observation of the writers, what are called "exhaustive 
papers" are read — exhaustive in more senses than one, for 
they not only exhaust the subject but the patience of the 
listeners. A fraction of time only can be devoted to the 
discussion of the topics introduced. A few of the more 
prominent and active may briefly discuss the subject, while 
the great body of the members remain silent and take no 
part. In my judgment there is force and truth in these 
criticisms. If the papers presented contained only the re- 
sults of the experience and observation of the writers; if 
they were brief and to the point, and if an opportunity 
was given to all who desired to participate in the discus- 
sion and present their views upon the topics introduced, 
much valuable knowledge would be gained which is now 
lost. Upon all subjects connected with medicine and the 
collateral sciences, the investigations should be original 
and the results stated concisely and clearly. Too many of 
the papers read are mere compilations, and which, while 
they may seem to show the research of the writers and 
their creditable acquaintance with medical literature, are 
neither profitable, instructive nor interesting. 

Then no national association and no written or formu- 
lated code of ethics was in existence^ — "everyone was a law 
unto himself" The amenities of professional intercourse and 
the obligations of medical men toward each other and the 



72 The Peoria Medical Monthly. 

public were then as well, perhaps better, observed than 
now. There was no national or state tribunal to take 
cognizance of any infraction of ethics, yet it was seldom 
an unprofessional act was committed. Is it so now ? Has 
not the passion for accumulating^ wealth, and an ambition 
that seeks notoriety rather than honorable distinction, that, 
regardless of the rights of others, casts aside any obstacle 
that seems to impede its progress, led to such violations of 
both the spirit and letter of the code as to degrade the 
profession in public estimation ? Then the c^octor, next to 
the minister, was the trusted friend and counsellor ot every 
family to whom he ministered. His advice Avas sought, not 
only professionally, but upon almost every other matter. 
He shared their joys, soothed their sorrows, and every pass- 
ing year added to and cemented the attachment and affec- 
tion between them. Now the doctor is regarded more in 
the light of a tradesman or mechanic, and is employed 
from the same considerations that a grocer, tailor or shoe- 
maker are. The strong ties ot gratitude and affection 
which then bound physician and patient together have al- 
most ceased to exist. Their relation is now placed upon a 
mere commercial basis, and for this the profession is more 
to blame than the public. Unfortunately there are too 
many in the profession who neither respect it nor them- 
selves. If they did they would respect the rights of their 
brethren engaged in the same pursuit. They would be 
guilty of no unfair or dishonorable acts, nor practice any 
petty acts, or indulge in degrading rivalries or jealousies 
to build themselves up at the expense of a competitor. 

Then woman was not known or recognized as a prac- 
titioner of medicine. If any of the sex engaged in prac- 
tice, it was as midwives, nurses, or the dispensers of roots 
and herbs; now the profession numbers in its ranks many 
intelligent, educated and able physicians of the other sex. 
Then they were not admitted as students to any medical 
college in the land, now schools have been established for 
their instruction, and the barriers which custom and edu- 
cation erected have been broken down, and the tendency 
of the times is to enlarge and widen their sphere of labor. 
As teachers and practitioners some are the peers and others 



Original Communications. 73 

will compare favorably in qualifications with those of the 
sterner sex. In some of the departments of medicine they 
are excelled by few of their male associates. And here let 
it be said, to the credit of the Illinois State Medical Society, 
that it was among the first to recognize the professional 
equality of the sexes by admitting women as members and 
selecting from their number one of its vice presidents. 
By this act it honored woman — honored itself and set an 
example worthy of imitation by others. 

In the department of surgery what wonderful advances 
have been made. Then disease and pain rested like a dark 
shadow over its victims, irradiated by no gleam of hope. 
Then the surgeon required a keen eye, a steady hand and 
a stout heart, to pursue his cruel task amid the groans and 
anguish of the gagged and bound sufferer writhing in 
unutterable pain; now, thanks to advanced knowledge 
and the skill thus acquired, but above all to that greatest 
of modern discoveries, anaesthetics, human suffering has 
been alleviated — the knife has lost its terror, for the pain 
it inflicts is no longer felt, and the most formidable diseases 
and injuries, which 50 years ago were left to end in death, 
are in many cases amenable to cure. Then the removal of 
any of the internal organs, or of tumors and growths upon 
certain external parts of the body, was never undertaken 
or even thought of by the wildest imagination; now many 
of the organs formerly regarded as essential to life have 
been removed wholly or in part with surprisingly success- 
ful results, and the lives of thousands in all parts of the 
world has been prolonged. Then the sufferer endured un- 
mitigated anguish, now it is no longer felt; every j)art of 
the human body is explored, and organs are exposed which 
it was then thought could not be done without causing 
death. All morbid growths, both internal and external, 
which were then regarded as incurable, are now either 
arrested in their development or removed. Electricity in 
its several forms has been brought into use, not only for 
this, but many other purposes with wonderful success, and 
the limit of its power and employment has not yet been 
reached. Then the surgery of the eye and ear was con- 
fined to a few simple operations, with uncertain results; 



74 The Peoria Medical Monthly. 

now these wonderful and delicate organs are treated with 
so much skill and success that cure of disease and restora- 
tion of function is the rule, accidents and organic disease 
the exception. Then surgical instruments and appliances 
were comparatively few, and often clumsily constructed: 
now they are wonderful examples of artistic skill and 
ingenious invention. Our ophthalmoscopes, laryngoscopes, 
spectroscopes, and other ingenious inventions now light 
many of the dark caverns of the human body, and reveal 
to sight hidden organs and their morbid conditions, thus 
rendering their treatment or removal more certain and 
practicable. Then little was known of that branch of 
medicine and surgery that bears the hard Greek name 
gynecology. A vaginal syringe, an astringent wash, given 
to the patient to use pro re nafa, composed the sum and 
substance of the treatment of the greater portion of female 
ailments. The revelations of the siDCCulum and other im- 
proved modes of examination and exploration were 
unknown; now, every medical college, however small or 
obscure, has its professor of gynecology, and the medical 
and surgical diseases of women are made a special study, 
and thanks to the knowledge and skill thus acquired, suf- 
fering women all over the civilized world have been rescued 
from pain and disease, and given a new hold upon life; no 
department of the profession has made greater progress 
than this, or whose labors and investigations have been 
attended with more beneficial results. For what it has 
done it deserves commendation in all respects save one — 
its nomenclature. Whatever may be the cause, whether 
it arises from the nature of the specialty or the idiosyn- 
crasies of its profession, it is hard to say, but for every 
ailment, every operation or procedure, a name of "learned 
length and thundering sound " has been ingeniously and 
laboriously constructed, for which a shorter and simpler 
one would convey as good if not a better idea. This fond- 
ness for the coinage of hard names may be proper, and not 
a legitimate subject for criticism, yet in reading works 
upon gynecology, one cannot sometimes avoid thinking 
that their author, like the character in the play, *had 
been at a feast of languages and stolen all the scraps." 



Original Communications. 75 

Then, in chemistry, pharmacy, the collateral sciences 
and their application to medicines, to the arts, to the alle- 
viation of suffering and the prolongation of human life, 
our knowledge was comparatively meagre and unsatisfac- 
tory; now chemistry has given us that greatest of all mod- 
ern discoveries as applied to medicine — anaesthetics. It 
has given us disinfectants and antiseptics, by which nox- 
ious gases and other germs of disease are neutralized or 
destroyed, health promoted and life saved. 

Pharmacy now furnishes the palatable and elegant 
preparations we daily prescribe, instead of the revolting 
and nauseous ones then in use. Little attention was then 
paid to that department of medicine; now colleges are 
established for the education of pharmacists, and instead 
of ignorant dispensers and compounders of medicinal 
agents, we have an intelligent and educated body of meix 
thoroughly qualified for their work. Then, of hygiene or 
the laws which promote individual and public health, little 
was known or understood; now we know the influence 
which foul air and bad sewerage has in causing and dissem- 
inating disease. Then little attention was paid to the 
prevention, introduction and spread of epidemic and con- 
tagious diseases; now a more effective quarantine rigidly 
enforced — a more complete isolation of the infected and 
other prophylactic measures, which a better knowledge of 
the laws of health have caused to be adopted, have 
deprived them of much of their terror, and added greatly 
to the sum of human life. 

Then in few of the states of the Union was attentfoni 
paid to public health, now many of them have created. 
State Boards, and almost every municipality has its health 
officers or authorities co-operating with them. In our owni 
state, the Board of Health created by its authority, has' 
during the few years of its existence accomplished credit- 
able results. "It has driven a large number of ignorant 
and fraudulent pretenders from the state, or compelled 
them to abandon the practice," and this, too, under the 
provisions of a "medical practice act" confessedly imper- 
fect and in many points objectionable. In enforcing quar- 



76 The Peoria Medical Monthly. 

antine and sanitary regulations, in circumscribing and pre- 
venting tlie spread of contagious diseases, notably the 
small-pox epidemic of the present year, the Illinois State 
Board of Health has exhibited a commendable zeal and 
discretion, and is entitled to the confidence and support of 
both the medical profession and the people. 

In many other particulars the contrast between the 
past and present, then and now, might l)e drawn. The ad- 
vances in ]jhysiology. pathology and the wonderful revela- 
tions of the microscope are of themselves fruitful themes 
for consideration. But I am admonished to refrain from 
trespassing upon your time or exhausting your patience by 
continuing the subject. Let me say in conclusion that 
judging from the past thus imperfectly sketched, the future 
for the profession of medicine is full of promise. It is 
perhaps not too much to say. that we niRj hopefully look 
forward to the time when one obstacle after another will 
be overcome, one new and useful discovery after another 
be made, until no physical evil, but death, will be beyond 
the reach of human skill. 

Ladies and gentlemen of the society, indebted to your 
kindness for the position I occupy to-day, — appearing before 
you as one of the only two now living who aided in the 
formation ot this society, — with the memories of half a cen- 
tury thronging around me, — worn and wearied with the 
journey of a long life, now near its end, I heartily thank 
you for this the last earthly honor I shall probably ever re- 
ceive. I trust our present session may be interesting and 
profitable, and that during the coming years and long be- 
fore another generation passes away, the Illinois State 
Medical Society will have achieved a reputation and exert 
an influence in the profession, worthy of the great state 
whose name it bears. For yourselves individually, let me 
express the hoj^e that each and all will prove loyal to the 
profession, and by neither word nor act bring dishonor or 
disgrace upon it, but strive to elevate and make it what it 
is. and ought to be, the highest and noblest of human 
pursuits. 



Original Commuxicatioxs. 77 

Art. v.— The Duty of the Physician to the 3Iedical Society. The President's 
Annual Address, Delivered before the Brainard District Medical Society. 
By S. T. Hckst, M. D., Greenview, 111. 

Members of the Brainard District Medical Society: 

It now becomes my dutj^, in accordance with our cus- 
tom, to tax your patience with some remarks as I retire 
from the honorable position which you oave me a year 
ago. 

As there have been no startling new discoveries in the 
healing art during the past j'ear, which I might recount 
here to-day: no important changes in the general principles 
governing our practice, I shall use the time alloted me in 
giving you some thoughts relative to the duty of medical 
practitioners of to-day, in regard to the advancement of 
all the interests pertaining to the profession generally. 
Permit me here to speak plainly upon this subject. The 
matter first of importance is supposed to be organization, 
medical societies or associations, or whatever name it may 
be knovrn by. Xow let us inquire what are medical socie- 
ties for, what their aim and destiny ? Society itself is a 
natural result of opposition from some source or other; it 
may be a human foe; it may be the adversities of life en- 
tailed upon the human race in the Garden of Eden, which 
branches out in all directions, such as poverty, misfortune 
and disease of every name bring to us. Mutual aid and 
comfort were designed in the creation of man. This idea 
has extended and expanded with the necessities of the 
case, until the present time; hence we now have almost an 
innumerable list of organizations, each intended to supply 
the wants of its members in its own particular sphere. 
Societies will pass out of existence only when there is no 
longer any need of them felt; and hence we may conclude 
that they are destined to continue till the end of time, 
though doubtless with many changes and improvements. 

The medical society is but a comparative young brother 
of the many organizations of the world, and yet it has 
done as much in the direction of its purpose, perhaps, as 
any one of the legion. The medical society, as are all 
others, is founded upon the principle enunciated long ago hj 
the wise man of Scripture fame who said, 'Tn the multi- 



78 The Peoria Medical Monthly. 

tude of counsel there is safety," and also upon the more 
modern axiom that "in union there is strength," the truth 
of which is admitted by all. But if we take the actions of 
the members of the medical profession generally, and more 
strictly the membership of our societies as our guide, we 
naturally conclude that a great many consider themselves 
safe enough, and abundantly strong for all practical pur- 
poses; for the majority, perhaps, are not members of any 
medical society at all, and very many of the membership 
are absent from the meetings more often than present. 
We know this to be true in our district society. 

Without detaining you here to-day to argue the impor- 
tance and usefulness of medical conferences, I shall rest in 
the belief that all who are alive and awake are thoroughly 
convinced that there are great benefits derived from them. 
But just how the good is to be appropriated and dissemi- 
nated, does not appear to be fully understood by a very 
large number of the profession. Were it so, the per cent, 
of attendance would surely exceed anything we now see. 
Punctuality in attendance marks the vigor and interest in 
any society, be it political, religious, humane, commercial, 
legal, medical or what not, and we may all see plainly that 
at this age, in medical associations, especially is this true. 
This being the case, let us inquire after the attendance of 
our district society; for we consider this of first importance, 
as it is primary, and a stepping stone to the higher organ- 
izations of the state and nation. 

I am sorry that this paper w^as commenced too late to 
obtain from our secretary the exact figures, but will ven- 
ture to approximate the ratio, and if any think I put it too 
low, an examination of the roll will perhaps satisfy the 
most skeptical. 

During the five years that this society has had an 
existence, the attendance has averaged about thirty-five 
per cent., and at some of our meetings as low as twelve 
and a half per cent., and some were attended by seventy- 
five per cent, of the membership. It surely does appear 
that all live members (and we all belong to that class) 
could find time to attend at least one-half of the meetings, 
which are held quarterly, and for but one day, and at a 



Original Communications. 79 

point where eighty per cent, may reach it by railroad and 
return the same day. Let each one find the cause for him- 
self, why this is so. What effect has this meagre attend- 
ance upon the society? First, it reduces us to the necessity 
of having most of our time taken up by extemporaneous 
matter, such as oral reports of cases and discussions of 
them, instead of the well-prepared essay of some member 
assigned to it at a previous meeting. Such essayist fre- 
quently is absent, thus we must take up some new^ subject, 
and the meeting is less profitable and instructive than it 
should be. 

Important committees are appointed annually which 
could be of much service, but this same disease has reached 
the committee, and we scarcely ever get a full report from 
them, because some or all are absent. Thus the effect upon 
our societ}' here, is to very much reduce its power to do 
good. 

What is the effect upon the membership? Those who 
remain away (and they are often in the majority) are nei- 
ther benefited themselves, nor beneficial to those who do 
attend. Any person isolated thus from the great and good 
influences of his fellows, is apt to grow selfish in his call- 
ing, stupid in his investigations, and contracted in his. 
view^s. This is so of any organization whatever; and just 
to the extent of his absence does he lose interest in all 
that pertains to the society. We here see that while the 
member is thus injuring his own usefulness, he is also crip- 
pling the society; and much of the material interest in 
each other, which is one of the prime objects of the society, 
is lost. The advancement in our ideas and know^ledge of 
the symptoms, pathologj^ and treatment of disease gained 
at the meetings, is also lost; and such a member is 
(whether he thinks so or not) less capacitated to fill his 
place in the high calling he has chosen, and has less con- 
fidence in his mode of management of his cases, than he 
would or should have if he attended the society meetings 
regularly, and participated in the various subjects brought 
before it. 

At a meeting like ours there is a fair opportunity given 
for everyone to give his views upon all questions under 



80 The Peoria Medical Monthly. 

discussion, and therefore there is no reasonable excuse for 
a want of interest. Why are matters thus ? Why not a 
larger rate of attendance ? Can it l:)e that the district so- 
ciety is too small a body for the consideration of the best 
talent we have ? That it has not attained great notoriety 
throughout the state and union, and therefore too small an 
affair to engage their attention? or lastly, is it because 
there is nothing more to learn, and they are not disposed 
to impart any of their knowledge to others less fortunate ? 
In either case the neglect to attend is bad, and the result 
is likewise bad for all concerned, and is not mitigated by 
the circumstances of the case in the least. I am not here 
speaking of the member who is unavoidably detained, for 
there are such cases and are always excusable. This same 
neglect of attendance seems to be affecting the state socie- 
ties in many of the states. Perhaps the average per 
cent, of attendance of our state society agrees very well 
with our district society. In fact if we make real, instead 
of nominal attendance the rule, I doubt whether it will 
have as good a showing; for many who are reported as at- 
tendants, spend much of the time of the session at other 
places than in the society, and only learn what is done at 
the session when the}^ receive their report. This I know 
from actual observation. The result of this may be seen 
in the great Empire State of New York, where a few weeks 
since, when but a small per cent, of the members were 
present, and we are informed mostly composed of the 
specialists, adopted a code of ethics of their own, which 
virtually severs its members from the regular school of 
medicine, and from the American Medical Association. 
And at this time, many of the best men of the state are 
loud in denunciation of the act. How much better it would 
have been for these men to attend and vote such measures 
down when proposed. 

Our own state societj' has been bored from time to 
time by papers which indicate that there is unrest on the 
part of some of its members, who seem to think that the 
profession is endangered b}^ something, and this something 
seems to be the ignorance of the average doctor graduating 
the last twenty years or more. Hence medical education 



Original Communications. 81 

papers, advocating advanced scholarship before admitting 
the student into the medical college, and others seemingly 
trying to remedy this supposed evil by repeated lecture 
terms at college: and still another class who seem to think 
that the present colleges are too lax entirely, and there- 
fore advocate the establishment of more colleges, etc. 
Such papers usually point to some new institution, with a 
big name for a send-off, where the noted pessimists shall 
be able to graduate a full class annually of the higher 
education sort, when indeed there are quite enough medi- 
cal colleges to supply the demand, and the attempts to 
advance the grade of the profession by increasing the num- 
bers of the schools where men are graduated has been a 
failure in any such purpose. All such three-termers, four- 
termers and all such nonsense and bosh, would only take 
up time that could profitably be devoted to subjects which 
at least would not savor so much of mercenary motive and 
selhsh ambition; and it is but fair to conclude that this 
will only be the case, when the society is fully attended by 
its members. The records of the meetings do not voice 
the profession of the state, because the greater part of the 
members are absent. 

Well, what can be done to remedy all this seeming 
diflBculty ? Let every member of the profession in our 
district, who is eligible under the constitution, be invited 
to become a member and urged to attend the meetings, and 
then urged to become memliers of the state society and 
punctually attend it; then will there be little danger of the 
general practitioners of our state being bored with papers 
intimating that all but the specialist are but ignorant em- 
pirics, by quoting the following: "These are the men of 
whom it has been said, they have three shots in their 
locker, iron for weakness, a strengthening plaster for back- 
ache and an alum wash for leucorrhoea."" 

While it is the duty of every member of the profession 
to Idij his foundation broad and deep, and continuously 
build upon it while life lasts, there is no better way to 
regulate the standard of capacity, than to let it regulate 
itself. The people will retire the old when better ones 



82 The Peoria Medical Monthly. 

come, and only then, and it is notable they are not retiring 
them very fast. 

Ladies and gentlemen of the Brainard District Medical 
Society, let us lay aside all petty strifes and jealousies, and 
by our mutual assistance and encouragement sustain our- 
selves amidst this clamor for favoritism and wild specula- 
tion, and see to it we each make one of the number at each 
of its meetings; by so doing we shall be able to thwart the 
design of all who would sever the bands which should ever 
hold our noble profession together. It is safe to say that 
the profession is not much cursed with persons who are 
idle in their calling, but is mostly made of live progressive 
material — of men and women who are well up in the liter- 
ature of our day, and especially the medical literature. 
(I mean in this the regular profession, and not quacks.) 

When united in purpose and working for the common 
good, then will we have an influence over legislation, and 
also over the high toned pseudo-educators of the medical 
world. The whole fraternity (and sisterhood too) will be 
honored by the world of mankind. The medical profession 
of the United States, already in the lead of the world in 
many things, has a bright future before it. 

Let us add our mite to the real rather than the fancied 
advancement heard of so often nowadays; and the millen- 
nium will in its own good time come, when the profession 
of the whole world shall be freed from all traces of ''Hahn- 
emania,"' '"Thompsonia," and all other noxious excre- 
scences with which it is now cumbered. Thanking you for 
the honor you conferred upon me a year ago, and for your 
kind assistance in the duties of the position, I bid you God 
speed. 



Art. VI. — On the Duties of the Public to the Medical Profestsioii. The An- 
nual Address before the Adams County Medical Society, May 8, 1883. By 
F. Drude, M. D., Quincj', 111. 

Gentlemen : The by-laws of the society require the 
l^resident to address you at the annual meeting, and in 
complying with this allow me to mention that we have ad- 
mitted during the past year four new members; liut Drs, 
Atwood, Clarke, Hess, Niles, Harris, Hoe and Roeschlaugli 



Original Communications. 83 

have left the city and county, leaving us three less than at 
the beginning of the year. A large number of our mem- 
bers are in arrears with their dues, and I would suggest 
that this society should take some steps to compel them to 
13ay up. According to the books of the secretary there are 
tifty-three dollars in the treasury. 

The Code of Ethics has quite an elaborate article on 
"'The Duties of the Profession to the Public," while the 
subject of the Obligations of the Public to the Physician is 
but slightly touched on. I may, therefore, be permitted to 
expatiate a little more on it. 

Well, educated people even, treat their physician often- 
times in a regardless manner, while they demand from 
their doctor that every consideration should be observed. 
How can we then expect, that men who have not the 
■slightest knowledge of the human body or of physical laws, 
will act with more regard toward us ? Frequently we hear 
such unwarranted expressions: ''That patient is under 
false treatment;" or, "if the doctor had applied leeches or 
bled him, he would have got well by this time;" or a sim- 
ilar phrase: "if the patient had sent from the beginning of 
the disease to Dr. B.. he would have been well by this time, 
but Dr. A. made too light of the case;" or, "our friend 
ought to have been treated by our celebrated homoeopa- 
thist." 

All such remarks show a vast amount of ill breeding, 
if not more — impudence; for no man should render judg- 
ment in a business which is too subtle and beyond his 
•comprehension and knowledge. 

Wealthy people — particularly such who have at a sud- 
den acquired riches — are but too apt to classify their doctor 
together with their servants, as there are many instances 
in the memory of old practitioners. Want of confidence 
and faith is often creative of great mischief, because an 
open exposition of the cause and nature of the disease 
would greatly facilitate and assist the physician in his 
efforts; but if the patient cheats the doctor by false stories 
and self-made hypothetical theories, it becomes almost a 
criminal act. 



84 The Peoria Medical Monthly. 

There is still another anomal}' often occurring: Pa- 
tients ostensibly have their physician visiting them and 
prescribing for them every day. while they do not use his 
remedies, but make use of the treatment of some quack or 
old woman clandestinely. This occurs but too often, and 
we do not know it; but later. One irord about the way 
and manner of summon iiuj a physician. There are cases in 
which speedy, immediate help is necessary, and it is wrong 
to refuse or defer a visit; but in a great majority of cases 
the patient has been sick for some time, may be for days. 
Now the messenger comes — in day time, or rather in the 
night hours — and wants the physician "right away." Such 
a desire borders next to impudence, and who has not expe- 
rienced this often? 

It may be pardonable, if a wealthy patient, for a slight 
ailment, prefers the physician to call, than that he calls on 
the doctor; but it is impertinent if he tells the doctor that 
he can afford to pay for a visit. 

Nothing however is so disgusting as to hear from the 
patient or his friends, propositions how to proceed in the 
treatment of a case. Some people have no feeling or 
understanding. How insulting to the physician are such 
like remarks: "Would not a steam bath be beneficial?" 
or "a good stomach strengthening remedy, I think, would be 
proper;" or "wdiat do j^ou think if we would make the 
patient sweat?" or "how would friction do?" or "how 
about magnetism? " It certainly requires all the patience 
and fortitude of the attending physician to keep cool and 
dignified. On such occasions a true physician has to over- 
come in a calm convincing manner all prejudices and 
superstitions, and show the patient a self-government and 
self-confidence which ultimately will prevail. 

It is certainly in bad taste and regardless, if a friend 
meets a friend and expresses himself: "How bad do you 
look! How pale and emaciated you appear! Have you 
been ill? You look dreadful!" But if a physician meet- 
ing an old customer uses indiscriminate language, it is 
unpardonable and often creative of great mischief. Fools- 
only make such exj)ressions. 



Society Transactions. 85 

If a physician seeks a recreation at a public place, he 
is very apt to be accosted and entertained by some hypo- 
chondriac about his real or imaginary ailment. Nothing 
is more disgusting. 

It is not my intention to commit plagiarism, but I am 
ready to confess that some leading ideas are derived from 
old Dr. Carl Bock's, professor in Leipsic, lectures on the 
material obligations of the physician and public. 



Ji0f«ty Wxm^^ttion^. 



Peoria City Medical Society. 

MEETING OF MAY 2, 1SS2, 

President J. L. Hamilton in the chair. Dr. Robert 
Roskoten read an interesting paper on "Herpes Zoster/' 
which is published on page 54 of this number. 

DISCUSSION. 

Dr. Coffey had recently had a personal experience 
with herpes eruralis, and gave a graphic description of its 
prodroma. He called attention to a peculiarity of this 
affection, to-wit: that while it may be considered in a cer- 
tain sense a constitutional disturbance, it is not accompa- 
nied with fever, but is manifested entirely through the 
nervous system. 

In the treatment of his own case he derived most 
relief after the application with a camel's hair brush of a 
15 per cent, solution of nitrate of silver, followed with the- 
free use of a solution of acetate of lead. Internally, he 
took quinine, and each morning a saline laxative. 

Dr. Murphy took exception to herpes being considered 
in any sense a blood disease. He regards it a nervous 
affection jjur et simple. Constitutional treatment of his 
patients has given no direct results, and is highly unsatis- 
factory, having in his hands no effect in shortening the 
duration of the disease. 

Locally he uses a firm piece of felt, covered by a thick 
layer of cotton saturated with olive oil, and binds it firmlj^ 
upon the affected parts. The results have been very satis- 
factory, relieving the pain quicker and more perfectly than 
any other method ever adopted by him. 

The bandage must be tight enough to rupture the ves- 
icles, and it is upon the rupture of the vesicles that the 
speaker thinks the merits of the application rests. 



86 The Peoria Medical Monthly. 

Dr. Brown has generally found some derangment of 
the digestive organs in patients suffering from herpes, 
which always requires proper treatment. He thinks this 
a self-limited disease and must run a certain course. Lo- 
cally, he uses the benzoated oxide of zinc ointment. 

Dr. Johnson considers the seat of the disease to be in 
the vaso motor nerves, not in the nerve trunks. 

Dr. Boal coincided in the opinion expressed, that this 
is purely a disease of the nervous system, and does not 
believe that it can be cut short by any treatment. Pallia- 
tives therefore have proved most satisfactory. 

The old popular treatment fifty years ago, was the 
blood from the tail of a black cat bound firmly over the 
eruption. He does not think the disease as frequent as it 
was twenty-five years ago. 

Dr. Stewart recommended as a topical application 
an emulsion of almonds containing a few drops of hydro- 
cyanic acid. This has afforded his patients more relief 
than anything he has ever tried. 

Dr. McIlvaine said that from the experience he had 
recently had with several cases of erysipelas, he would use 
in herpes a solution of a drachm of borax dissolved in 
one ounce of gl3'cerine, and thought this would afford 
speedy relief. He also mentioned the local use of tincture 
of iodine, which in some cases seemed to cut short the 
trouble. 

Dr. Coffey wished to correct a misapprehension 
arising from his former remarks. He regards herpes as a 
nervous disease, but with some symptoms of constitutional 
disturbance. 

Dr. Hamilton said he regarded herpes as a self-limited 
affection, and did not think abortive efforts of any avail. 
He used palliative treatment and let time cure his patients. 



Brainard. District Medical Society. 

This society met in Mason City, HI., April 27, 1SS2, the 
following members being in attendance: Drs. P. L. Diffen- 
bacher. of Havana; J. W. Newcomer, J. D. Whitley and 
C. E. Elliott, of Petersburg: J. S. Kennell3% of Easton; S. 
T. Hurst, of Green view; M. Hurst, of Sweetwater; Robei't 
Barger, of Hopedale; W. S. Watson, of New Holland; 
Elizabeth S. Xorred and Catherine Miller, of Lincoln; J. 
P. AValker, A. M. Bird, 0. P. Crane, J. W. Spear, J. A. 
Walker, of Mason City; Nathan Holmes, of San Jose; A. 
E. Prince, of Jacksonville; A. F. Burnham, of Ashland; J. 
S. Geigley, of Lewistown; P. A. Rosen berger, of Greenview, 



Society Transactions. 87 

and Dr. Fitz, of Chicago. This being the annual meeting, 
officers were chosen for tiie coming year as follows: 

President, Dr. A. M. Bird, of Mason City. 

Vice-President, Dr. Elizabeth S. Norred, of Lincoln. 

Secretary, Dr. J. A. Walker, of Mason City. 

Treasurer, Dr. W. P. Walker, of Teheran. 

Censors, Drs. Robert Barger, W. S. Watson, J. S. 
Geigley, C. E. Elliott, Nathan Holmes. 

President Hurst on retiring from the chair delivered 
an eloquent address on the duties of medical practitioners 
of to-day in regard to the advancement of all the interests 
pertaining to the profession generally. (See page 77.) 
Several papers were read; one by Dr. C. E. Elliott, describ- 
ing a case of injury to the head by a bursting gun; and an 
interesting paper by Dr. J. P. Walker, on stomatitis materna, 
which elicited considerable discussion. The afternoon ses- 
sion was principally taken up by the discussion of the sub- 
ject announced at the January meeting, viz: Abortion; 
its causes, prevention and after treatment; participated in 
by most of the members present. 

President appointed as delegates to State Medical 
Society, Drs. C. B. Maclay, A. F. Burnham, Elizabeth S. 
Norred, W. V. Guttery, Catherine Miller, J. S. Conway, W. 
S. Watson, N. Holmes, G. H. Sanford, J. A. Bolinger; and 
as delegates to American Medical Association Drs. Chas. 
H. Norred, A. M. Bird, J. W. Downey, A. E. Prince and J. 
A. Glum. Neurasthenia was announced as the subject for 
discussion at the July meeting. 

Dr. A. E. Prince of Jacksonville operated before the 
society for strabismus, and delivered a very interesting 
lecture describing and illustrating a simple method of per- 
forming the operation of paracentesis of the membrana 
tympanic. Meeting adjourned to meet in Mason City, EL, 
July 27, 1882. 

J. A. Walker, Secretary. 



Illinois State Medical Society. 

The following is the report of the nominating commit- 
tee, which was unanimously adopted. We give it space as 
a matter for reference: 

Dr. N. S. Davis of Chicago, chairman of the nomina- 
ting committee, presented a report which was read: 

Next place of meeting, Peoria, on the third Tuesday 
in May, 1883. 



88 The Peoria Medical Monthly. 

OFFICERS 

President, A. T. Darrah, Tolono. 
First A'ice-President. L. (}. Thompson, Lacon. 
Second Vice-President, W. A. Byrd, Quincy. 
Treasurer, J. H. Hollister, Chicago. 
Permanent Secretary, S. J. Jones, Chicago. 
Assistant Secretary, T. M. Mcllvaine, Peoria. 
Judicial Council, E. Ingals, Chicago; F. B. Haller, Yan- 
dalia; Wm. Hill, Bloomington. 

STANDING COMMITTEES. 

Practical Medicine — N. S. Davis, Chicago: B. M. Griflith, 
Springfield: J. F. Todd, Galva. 

Surgery — J. E. Owens, Chicago; J. T. Stewart. Peoria; 
M. Reece. Abingdon. 

Obsterics — E. L. Herritt, Jacksonville; G. W. Jones, 
Danville: Ellen A. Ingersoll, Canton. 

Gynecology — David Prince, Jacksonville; C. Cheno- 
weth. Decatur: E. S. Xorred. Lincoln. 

Ophthalmology and Otology — S. J. Jones, Chicago: J. 
P. Johnson, Peoria: J. G. McKinney, Barry. 

Drugs and Medicines — T. J. Pitner, Jacksonville; 
Herbert Judd, Galesburg; P. H. Garretson, Macomb. 

Necrology — E. Ingals, Chicago; AVm. Hill, Blooming- 
ton; Washington West, Belleville. 

SPECIAL COMMITTEES. 

Simple renal catarrh — J. N. Danforth, Chicago. 

On the practicability and desirability of separating 
the work of teaching in medicine and licensing to practice 
— S. Booth, Sparta; E. P. Cook, Mendota; M. A. McClelland, 
Knoxville. 

The diagnostic peculiarities of malignant growths — 
Christian Fenger, Chicago. 

Committee of arrangements — John Murphy, Anna S. 
Adams, J. P. Johnson. J. T. Stewart, of Peoria, and J. 
H. Reeder, of Lacon. 



Central Illinois Medical Society. 

Bloomington, Illinois, May 4, 1882. 
The Central Illinois Medical Society met in regular 
annual session in this city. May 3, 1882. There was a pretty 
large attendance. In the absence of the president. Dr. J. 
Y. Campbell, of Paxton, presided. Dr. T. F. Worrel de- 
livered a neat and appropriate address of welcome, to which 
a response was made in a similar strain on behalf of the 
.society, by Dr. A. H. Scott, of Mansfield. Dr. A. L. Xorris 



Periscope. 89 

made a very interesting report on "Pneumonia." Through 
the report on "Fashion in Medicine," by Dr. T. F. Worrel, 
ran a very pleasant vein of satire. Dr. R. Wunderlich read 
an interesting and carefully prepared paper on the ''xEtiol- 
ogy of Zymotic Diseases." The report on "Syphilis" by Dr. 
J. L. White, contained many original ideas. For the re- 
port on "New Uses of Old Remedies," by Dr. H. 0. Pauld- 
ing, see page 57 of this number. Dr. S. T. Anderson de- 
livered an address in the evening on the subject of "Alcohol 
as a Food, Beverage and Medicine," in which he took the 
scientific ground that alcohol was really a food. Dr. A. T. 
Barnes read an exhaustive paper on the "Responsibility of 
Insane Criminals," in which he took a somewhat Spartaii 
view of the subject. The next meeting of the society will 
be at Paxton. The officers elected at the present meeting 
were : Dr. D. L. Jewett. First Vice-President; Dr. L. S. Wil- 
cox, Second Vice-President; Dr. C. T. Orner. Secretary and 
Treasurer. The Board of Censors consists of Drs. E. Wen- 
ger, W. L. Pollock and J. Y. Campbell. The exercises ended 
with a banquet and the meeting was a decided success. 



Croupous and Diphtheritic Ophthahnia— Ophthalmia Neona- 
torum. 

Dr. H. Knapp, at the New York State Medical Society, 
February 8, 1S82, speaks of croupous and diphtheritic oph- 
thalmia and ophthalmia neonatorum. The symptoms and 
course that he gives of the croupous and diphtheritic con- 
junctivitis is that they begin with those ol acute catarrh 
or a blennorrhoea, and soon become characterized by the 
deposition of whitish membranes on the retrotarsal folds 
of both lids, extending towards the fornix of the conjunctiva 
and the free edge of the lids, as far as the so-called papil- 
lary body is found. The membranes consist of coagulated 
fibrin, enclosing lymphoid cells in varying quantities. 
They cover the palpebral conjunctiva in patches, or as con- 
tinuous layers, and are characterized by several points 
which he mentions, viz.: 

1. In diphtheria the lids are very stiff and hard; it is 
difficult or impossible to evert them; in croup the lids are 
supple and soft, and can be easily everted. 

2. The diphtheritic lid is unusually hot and painful 
to the touch, whereas the croupous lid can be handled 
without causing much pain. 



90 The Peoria Medical Monthly. 

3. The diphtheritic exudations are continuous from 
the deposits on the surface through the superficial and 
deeper hiyers of the conjunctiva, whereas the croupous ex- 
udation is a surface deposit onl)\ 

4. The diphtheritic membrane cannot easily be re- 
moved, but must be torn off with some force, leaving the 
subjacent tissue pale and ragged; whereas the croupous 
membrane can be wiped off as a whole, leaving the 
subjacent tissue dark-red, bleeding and uneven — finely 
nodular. 

5. The tissue of the diphtheritic lid when cut into is 
anaemic and has, in the developed cases, a white, lardaceous 
appearance, whereas the tissues of the croupous lid is highly 
congested and soft. 

6. The diphtheritic process leads to mortification of 
the invaded conjunctiva, the croupous process to prolifera- 
tion and cauliflower or polypoid excrescences. 

7. Diphtheria readily extends from the lids to the 
bulbar conjunctiva and the cornea, whereas croup is long 
limited to the lids, and only in the severest cases affects 
the cornea, and seems always to leave the scleral conjunc- 
tiva free. 

In his treatment for croupous or diphtheritic conjunc- 
tivitis he abstains from all kinds of irritating medication^ 
as long as the formation of the membranes is still active, 
but persistently applies uninterrupted applications day and 
night of iced compresses to the lids, and carefully washes 
away the secretions with a soft sponge, dipped in a weak 
solution of chloride of sodium, chlorate of potash or the 
like, as long as the inflammation is progressing or at its. 
hight. As soon as the swelling decreases and the mem- 
branes break off, he limits the cold applications to an hour 
every morning, noon and evening, and then gradually leaves 
them off. He then applies a weak solution of nitrate of 
silver or mildly touches with the sulphate of copper crys- 
tals. In ophthalmia neonatorum he uses the same persis- 
tent cold application, with the precaution that the lids 
must be every fifteen or twenty minutes gently separated 
and the secretions carefully washed out with a fine soft 
sponge. Keeps the room moderately dark, encourages the 
opening of the eyes, as it is beneficial in two ways: First, 
the movements of the lids beat the corrosive secretions out 
of the conjunctival sac. Secondly, thej^ accelerate the cir- 
culation in the affected parts, thus diminishing the stasis 
and infiltration. After the child has opened his eyes, ha 
thinks the danger is over, but a weaker solution of nitrate 
of silver (one-tenth to one-fifth per cent.) may be useful. — 
Archives of Ophthalmology, Vol. XL, No. 1. 



Peeiscope. 91 

Skin Grafting, Our Present Knowledge of. 

(Dr. C. Johnson in International Surgenj, Vol. 1, page 
549.) 

a. — It affords an admirable means of accelerating and 
facilitating cicatrization. 

b. — The pellicle produced by its aid is less prone to 
contraction and contracts less than an ordinary cicatrix. 

c. — The deeper layers of the epidermic elements are 
the chief factors of growth. 

d. — The growing cicatrix is formed at the expense of 
the embroyonal cells of the granulating surface, stimu- 
lated into activity by the presence of the living cells of the 
graft. 

e. — The stimulus first showing energy in and about cen- 
tral islands of new growth, induces activity at the hitherto 
dormant margin of the ulcer. 

/. — Grafts may retain vitality, and be effective long- 
after separation from the body. 

g. — Small grafts the size or a millet seed, for example, 
are generally preferable to larger ones, although much 
larger grafts have had their successes and advocates. 

h. — Grafts should be obtained from the patient himself, 
if possible, but in all cases the danger of specific inocula- 
tion ought to be present in the mind of the surgeon who 
borrows grafts from one subject for application upon an- 
other, or who practices heteroplasty. 

i. — Grafts furnished by the aged are less disposed to 
adhere than those obtained from the young, and sometimes, 
fail entirely. 

j. — Grafts obtained from one race of men may be suc- 
cessfully used on individuals of another race; and animal 
grafts may be transplanted upon human beings and pro- 
voke cicatrization. 

k. — Foul surfaces, or those of persons in bad health,, 
will refuse to accept good grafts; but with improvement or 
establishment of the health of the individual bearing an 
ulcer, and the appearance of healthy granulations, a fav- 
orable result of skin grafting may be anticipated. 

/. — Finally, the great benefits accruing from successful 
skin grafting far outweighs its drawbacks, which are the 
pain of the operation, and, unless amputated limbs be 
utilized, the consecutive pain in the parts yielding the 
grafts, whether these be autoplastic or heteroplastic. 



92 The Peoria Medical Monthly. 

Mammary Glaud, Relation Between Tumors of. 

Dr. S. W. Gross {Medical News and Library), from an 
elaborate study of this subject obtains the following re- 
sults : 

1. That from a genetic standpoint there is a distinct 
connection between adenoma and carcinoma, since both 
originate from the glandular constituents of the gland. In 
the former neoplasm, however, there is a numerical in- 
crease of the lacteal glands; in the latter, there is merely a 
multiplication ot the epithelial cells, which extend into 
the lymphatic vessels and the perivascular sheaths of the 
blood-vessels. From a clinical standpoint, adenoma is a 
benign tumor, and carcinoma malignant. 

2. That sarcoma has neither a genetic nor a structural 
affinity with adenoma or carcinoma, but that it resembles 
the latter in its malignant attributes. 

3. That, in view of the recurring tendency of ade- 
noma after simple enucleation, the entire breast should be 
extirpated with it. 

4. That surgical intervention in sarcoma and carci- 
noma not only retards the progress of the disease by pre- 
venting dissemination and the development of visceral 
tumors, but it also not infrequently results in permanent 
recovery. 

5. That local reproductions in sarcoma and carcinoma 
do not militate against a final cure, provided they are freely 
excised as soon as they appear. 

6. That lymphatic involvement does not forbid opera- 
tions in carcinoma, since infected glands were removed in 
nearly one-third of the examples of permanent cure. 

7. That the subjects of sarcoma and carcinoma are, 
almost without exception, safe from local and general re- 
IDroduction if three years had elapsed since the last oper- 
ation. 

8. That all sarcomata and carcinomata of the mam- 
mary gland, if there are no evidences of metastatic tumors, 
and if thorough removal is practicable, should be dealt with 
as nearly as possible by amputating the entire breast and 
its integuments, and dissecting of the subjacent fascia. In 
carcinoma, moreover, the axilla should be opened with a 
view to its exploration and the removal of any glands 
which were not palpable prior to interference. 



Professor Pirogoff, by whose name one of the best 
.known surgical operations is called, und who died a short 
time ago of epithelial cancer, which perforated the hard 
palate, left property to the value of 75,000/. 



Therapeutic Notes. 



93 



CONSTIPATION. 

Dr. J. C. Frye gives us the following, 
"n'hich he recommends very highly in 
■cases of chronic constipation: 
9 n. ex. cascara segrada, 2 oz. 

Tr. belladonnse, 2 dr. 

Tr. nucis vom., 2 dr. 

Acidi nitro-muriat. dil., 3^ oz. 

Syrupi, 2 oz. 

Aqu*, 3 oz. 

Dose, a teaspoonful night and morn- 
ang. 

CHAFE. 

I^ Zinci acetatis, 15 gr. 

Morphine acetatis, 2 gr. 

• Glycerin, 2 oz. 

Aqure rosse, ' 2 oz. 

M. Apply two or three times daily 

— Med. and Siij-g. Reporter. 

NASAL CATARRH. 

^ lodoformi, 40 gr. 

Ex. geranii sol., 10 gr. 

Acid, carbol., 15 min. 

Vaselini, 1 oz. 

M. Saturate a bougie made of ab- 
sorbent cotton, with the above oint- 
ment and introduce it into the nasal 
passage, leaving it over night. Repeat 
for a week or ten days. — Medical (Sum- 
mary - 

DIARRHOEA OF PHTHISIS. 

5 Fl. ex. coto bark, 60 min. 

Tr. cardamom, comp., 60 min. 

Mucil. acacciae, 3 dr. 

Syr. simp., 3 dr. 

Aquai, q. s. ad. 2 oz. 

M. Dose, one tablespoonful. — Th^ 
JPractitioner . 

PrRGATITE LINIMENT. 

i^ Tr. colocynth, 1 



Castor oil. 



oz. 

oz. 



M. The tincture of colocynth is to 
"be made from stronger alcohol and 
•one-tenth of its weight of colocynth 
deprived of seeds. A teaspoonful of 
the liniment is to be rubbed on the ab- 
domen night and morning. — Drug Cir- 
cular. 

TERTIARY SYPHILIS. 

3 Iodide potassa, 2% dr. 

Hydrarg. bi-chlor., 2 gr. 

Fl. ex. sarsap., 2 oz. 

Tr. cinchonse comp., 1 oz. 

Tr. geutianse comp., 1 oz. 

M. Sig. Teaspoonful after each 
me:il in a wineglassful of sweetened 
w:itor. — Chemists and DruggiaW Gir- 
cul'i r. 



DEPILATORY OINTMENT. 

5 Carbonis ligni, 1 dr. 



Calcis ustse, 
Sodii carbonas, 
GlVcerinae, 
Adipis, 



4 dr. 

1 oz. 

1 oz. 

7 oz. 



M. This is applied to the skin for 
ten or twelve days, when the latter as- 
sumes a rose tint and the hairs are ex- 
tracted without pain. — Drug Circular. 

BLIND PILES. 

IJ Ex. belladonae, 5 gr. 

lodoformi, 1 gr. 

Plumbi acetas, 1 gr. 

VaselinsB, 75 gr. 

M. Apply three or four times a day, 
after bathing the swellings with warm 
water. — Br. Posqua. 

ECZEMA OF THE HANDS. 

5 Boracic acid, 2 dr. 

Aq. bul., 3 oz. 

Glycerine, q. s. ad. 4 oz. 

M. Sig. Apply thrice daily with 
friction. — Med. Brief. 

ENLARGED GL.\N"DS. 

B Tr. iodini, % oz. 

Acid, carbol., 20 min. 

Aq. ammon., 2% oz. 

M. Sig. Apply morning, noon and 
night. — Brief. 

FACIAL NE€RALGIA. 

IJi Croton chloral hydrate, 2 dr. 

Glycerine, 2 oz. 

Aquaj, q. s. ad. 4 oz. 

M. In ordinary cases give teaspoon- 
ful three times a day. If the symp- 
toms are quite urgent, a teaspoonful 
every two hours until pain is relieved. 
— Medical Bulletin. 

APTHOCS SORE MOUTH OF INFANTS. 

5 Sodii sulphite, 30 gr. 

Glycerini, % oz. 

Aquae purse, 3^ oz. 

To be used on a swab every two 
hours. — College and Clinieal Record. 

APTHOrS ^TTLVITIS. 

Paint the vulva, each day, thickly 
with iodoform, the labia being pre- 
vented from adhering by a small 
amount of charpie placed between 
them. — Chicago Med. Rev. 

CYSTITIS. 

I^ Acidi benzoici, 10 gr. 

Sodii biboratis, 10 gr. 

Infus. buchu, 2 oz. 

M. Sig. This amount three or four 
times a day. 



t'^t.ie: 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jefferson Street, .... PEORIA, ILL. 

,** A.11 exchanges, books for review, and communications must be addressed to the 
Editor and Publisher. 

***The publication day of tliis journal is on or about the 10th of each month 
,**To subscribers! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 

(gaitorial gfijartmcttt. 

The Quincy Meeting of the Illinois State Medical Society. 

Since the volume of transactions of this society will 
soon be placed in the hands of the members, it has been 
thought best not to print any extended or detailed report 
in this journal. We will therefor offer some random notes 
of the meeting, and thoughts suggested hj what was, and 
"was not done. 

The attendance was small: this may be accounted for 
in several ways. The place of meeting being at an 
extreme side of the state, and necessitating the loss of 
much time by members in reaching it. This w^ould seem 
to indicate the propriety of locating the yearly meeting 
permanently at some central and easily accessible location. 

Apart from the matter of location, the paucity of 
members in attendance might be accounted for, by the 
lamentable lack of interest taken by a majority of physi- 
cians in matters pertaining to professional legislation. 
The full aim and purpose of a state medical society is not 
attained by the reading of papers on topics purely medi- 
cal, and discussions of the same. A state society should 
hold the same relation to all matters pertaining to medical 
affairs, as does the state legislature to the interests of the 
citizen, and it is rather strange that all physicians do not 
appreciate the privilege and duty of attending its meet- 
ings and taking part in its proceedings. Some times, 
though rarely, resolutions brought before the society on 



Editorial Department. 95 

questions relating to the status of the profession, and 
which, by securing the dictuni of so large and representa- 
tive a body of men, carry much weight in courts of law 
and in the ej^es of the people. 

With the rapid multiplication of books and medical 
journals the society meetings afford no longer the only 
opportunit}' for introducing novelties in treatment or the- 
ories concerning the origin of disease, and to maintain a 
sufficient interest to keep the society alive more time must 
be devoted to matters purely legislative. 

With this idea then, but little of importance was 
accomplished at the Quincy meeting. Several papers were 
read on the subject of the advancement of the professional 
standard and state legislation, but no adion was taken. 
Some discussion was had upon the treatment of insane 
criminals, but nothing icas done. 

Upon a question of utmost importance to physicians, 
professionally and sociall3\ that of a revision of the code 
of ethics, not a word was spoken. Other societies, both 
local and state, have put themselves fairly upon the record, 
as favoring honesty and the right, but this societj^, repre- 
senting the four thousand physicians in this empire state 
of the West, adjourned with not a word concerning this 
question to go upon its printed transactions. If we mis- 
take not, the ''sin of omission" will be brought forward as 
evidence that the profession of Illinois favors the abroga- 
tion of the code of ethics, and indiscriminate consultation 
with every thing that has secured a certihcate from the 
State Board of Health. We know that such is not the 
decision of the regular profession of this state, although 
nothing appears on record to the contrary. 

Many of the papers read, admirable as they were, 
consumed too much time in their reading, thus leaving no 
time for a discussion of the subjects to which they related. 
This is one great cause of the seeming lack of interest on 
the part of members. There is no "life," no "snap" in the 
discussions. The reading of lengthy papers saps the 
interest that otherwise might be felt, and reduces the dis- 
cussion to the utterance of but one or two men. 



96 The Peoria Medical Monthly. 

The words of the "Fathers in Medicine" should al- 
ways be received with due respect, but when the "Fathers" 
by reason of their position and vast experience monopolize 
all the time of the societ}', frowning down any opposition, 
especially if it comes from younger men. the time has 
surely come for a change in the by-laws, absolutely limit- 
ing the time alloted to each speaker and the number of 
speeches allowed to each member. We mention this in 
no unkindly feeling, but knowing the dissatisfaction which. 
existed among many members present at the Quincy meet- 
ing, we believe that the matter must be remedied in the 
best interests of the state society. 

The delegates were heartily received by the profession 
of Quincy, and a pleasant time was had by everybody. 



Is There a Tubercle Parasite? 

The promulgation of the germ theory, but a few years- 
ago, has almost revolutionized all pre-existing theories on 
the etiology of many forms of disease, and so firm a hold 
has this latest theory taken upon the minds of a large pro- 
portion of the medical profession, perhaps a majority, that, 
it is to this same germ theory we look for our greatest dis- 
coveries and consequent achievements. When the fact is 
stated, as it has been on good authority, that fully one- 
seventh of the deaths of the human race are due to tuber- 
cular disease, and that at least one-third of those who die 
in active middle life are victims to the same dread foe of 
life, it must be conceded that the necessity of a correct un- 
derstanding of the causes of this disease is paramount in. 
the domain of medicine. 

Appreciating the necessity for this, the profession is 
always ready and eager to learn anything which tends ta 
this desired result. 

It has been assumed by many investigators, upon 
purely circumstantial evidence, that tuberculosis is a 
chronic infectious disease, and the theory of its parasitic- 
origin has been stoutly defended by others, but until the 
present time, no positive proof has been advanced. 



Editorial Department. 97 

Dr. Edward Koch, in a paper read before the Physio- 
logical Society of Berlin, detailed the experiments upon 
which he bases the conclusion that tubercle, wherever 
found, is the direct result of the hac'dlus tuhercidosis. In 
numerous experiments he has cultivated this germ, through 
successive generations, and upon again placing it in the 
animal economy, (of guinea pigs, rabbits, etc.,) it has 
rapidly reproduced the original disease. 

The recent brilliant success of Pasteur in destroying 
the virulence of the bacillus anthrax, gives us ample 
grounds for hoping that some similar method can and wall 
be devised for the control and annihilation of tuberculosis. 

Professor Baumgarten has arrived at similar conclu- 
sions with those of Dr. Koch. Professor John Tyndall, of 
England, is already a strong believer in the truth of this 
theory, and many of the foreign medical journals accept it 
as conclusively proven. 

Other experiments will follow, and the eyes of the 
medical profession in both hemispheres will eagerly scan 
the latest publications to learn of their progress and 
results. 

Knowing the cause of a disease, however, does not 
always indicate that the best plan of its treatment will be 
speedily attained, and we must not base our hopes too high 
for a speedy extermination of consumption. The London 
Lancenf closes an editorial on this subject with the follow- 
ing words: "The pathological importance of the discovery 
of the proximate cause of this frightful scourge of the 
human race cannot be overestimated; nor is it possible to 
foretell the practical results to which it may lead." 



A Word of Explanation. 

The charts which are offered to new subscribers are sent 
only to those who remit directly to the publisher. We 
cannot afford to pay a commission to canvassers and give 
this premium besides. We offer the charts to induce phy- 
sicians to remit by mail; neither can we give these charts 
on renewals, and they have never been offered in this way. 
The absolute rule is to send the charts only to ?iew subscrib- 
ers who remit directly by mail. 



98 The Peoria Medical Monthly. 

Notes and Comnieiits. 

Several books and pamphlets have l)een received, due 
credit for which will be given next month. 

Bound volumes of Vol. II. are nearly readj'^ for deliv- 
ery. They will be sent with the current year for only $2. 

The Swiss National Council have made vaccination 
obligatory in Switzerland, by a vote of ninety to twenty- 
three. 

Contributions to the ''Therapeutic Notes" are especially 
I'equested. If you have a formula that has given j^ou good 
results, let us have it for the beneht of others. 

There is no greater blunder than to object to a journal 
on account of its large advertising department. The size 
of this department is the key to the journars success and 
the index of its prosperity, — GaiUard's Medical Journal. 

The Canada Medical Becord is authority for the state- 
ment that for the first year of Sir Astley Cooper s practice 
his income was $26; the second, |130; the third, $320; the 
fourth, $480; the fifth, $500; the sixth, $1,000; the seventh, 
$2,000; the eighth, $3,050; the ninth, $5,500. In 1815 he 
made $105,000. 

A great many express their astonishment at our being 
able to give so large and good a journal for a dollar. The 
reason is, that we are so heartily supported by the profes- 
sion everywhere, and because' ''once a subscriber is always 
a subscriber" seems to be the motto of nearly all of our 
friends. Very few have to be asked to renew their sub- 
scriptions. 

In lecturing on the recognition of the sex of the child 
in utero, a noted professor was expatiating on the theory 
of the pulse rate, claiming that if the pulse beat 120 per 
minute the child was a boy; it 140 per minute the sex was 
female. A terribly dull student electrified the class by in- 
quiring, "whether, if the pulse rate was 130, would the re- 
sult be a hermaphrodite?" 

There are less than one hundred who are in arrears 
with their renewal to this journal. If you are one of these 
few, please take the trouble to forward the amount due us 



Editorial Department, 99 

at once. Less than two per cent,, from all causes, have 
dropped this journal since it started. Over one per cent, 
of these were from death, and but only four have ordered 
it discontinued. We appreciate this more than amount of 
spoken praise. 

With characteristic hospitality the profession of St. 
Paul have left no stone unturned to entertain the delegates 
to the American Medical Association. We learn from a 
daily paper, that over five thousand dollars have been raised 
for the purpose, and now from a circular issued by the 
committee of arrangements, the follow^ing excursions are 
offered: 

The St. Paul, Minneapolis and Manitoba Railroad will 
give passes to every delegate and to ladies accompanying 
them, over all divisions of its road, for the entire month of 
June. Their road runs through the celebrated Red River 
Valley, and the great wheat farms to Winnipeg. It con- 
nects Minneapolis and Lake Minnetonka (the largest 
watering place in the state, with four large hotels,) with 
St. Paul. 

The Northern Pacific Railroad offers free transporta- 
tation for the month of June to delegates and ladies ac- 
companying them, to the Yellowstone Valley and return. 

The St. Paul and Duluth Railroad offers free passes to 
delegates and ladies accompanying them, over their line to 
Duluth on the north shore of Lake Superior and return. 

The Lake Superior Transit Company have offered a 
complimentary excursion down the lake and return, from 
Duluth, one day immediately after the meeting. 



Chicago m^edical College 

The following changes have recently been made in the 
faculty of the Chicago Medical College: Dr. Rea has re- 
signed the Chair of Anatomy to accept the Chair of Surgery 
in the College of Physicians and Surgeons. Dr. E. W. 
Jenks has resigned the Chair of Gynaecology, and Dr. E. C. 
Dudley has been elected as his successor. Dr. Christian 
Fenger has been elected to the Chair of Pathology made 
vacant by the resignation of Dr. Hollister, who takes the 
Chair of Clinical Medicine. Dr. 0. C. DeWolf, Health Com- 
missioner, has been elected Professor of Hygiene and State 
Medicine. Prof. J, H, Long has been elected to the Chair 
of Chemistry. Dr, Quine resigns the Chair of Materia 



100 The Peoria Medical Monthly. 

Medica that he may devote his whole energy to the Chair 
of Therapeutics. Dr. Walter Hay has been appointed his 
successor. Dr. J. E. Owens has been made Professor of 
Surgical Anatomy, and Dr. F. C. Schaeffer Professor of De- 
scriptive Anatomy. A new Chair of Dental Diseases has 
been established, but as yet remains unfilled. Dr. E. 0. F. 
lioler, who has so long been seriously ill. says he is fully 
restored and will be ready for active work at the next ses- 
sion. Dr. Roswell Park, Demonstrator of Anatomy, has 
resigned, but as yet no one has been appointed to fill his 
place. — Med. Bevieiv. 



An Extra Large Number. 

To make room for the inaugural address of the Presi- 
dent of the Illinois State Medical Society, we have added 
quite a number of pages to our reading matter. This num- 
ber contains ■ — pages of reading matter, and is as large as 
any of the two or three dollar journals. If the support of 
the profession warrants us, it will be no long time before 
every number will contain sixty or more pages of good 
practical pTatter We are determined to give the largest 
and best monthly published at anything like the price we 
ask for this. 



Epithelioma of Cervix Uteri. 

Dr. Sims, in the American Journal of Obsfefrics, gives 
some rules for operating. He says: Do not amputate an 
epithelioma of the CGrvix uteri on a level with the vagina, 
but exsect the whole of the diseased tissue; arrest bleed- 
ing with a styptic lotion, then cauterize the granulations. 
When the slough is produced, use carbolized warm water 
till cicatrization is complete. When cured, put the patient 
on arsenic, and examine every three months; if fungous 
granulations show, remove them with caustic. 



Chloral Enemata in Vomiting of Pregnancy. 

Dr. Vidal of the St. Louis Hospital (Paris Medicale,. 
Nov. 12, 1881), claims that they will yield good results. 
Fifteen grains of chloral hydrate are ^iven by enemata 
twice daily, an hour before meals, in halt a pint of infusion 
of orange leaves. Dr. Dussand, of Marseilles, claims simi- 
lar good results from a like course of treatment. — Chicago 
Med. Eeview. 



The Peoria 
MEDICAL MONTHLY. 



Vol. riT. AUGUST, US82. Xo. 4. 



(Driginal (ffommuuifationsi. 



Akt. I. — The Stomach Pimip in Some of the Convnlsions of Childhood. By 

William A. Byrd, M. D., Qiiincv, 111. 

I presume that uo physician ^vho has wunessed the 
terrible spectacle of a child in convulsions but will wel- 
come any addition to his armameniarium for the safe and 
speed}' relief of the sufferer. Having witnessed many 
cases where the coma was so profound, and the muscles 
were so rigid, that the only hope of relief lay in the admin- 
istration of chloroform by inhalation, which only relieves 
a sjmiptom without removing the cause, made me ponder 
seriously for some better plan than had been so far sug- 
gested. As most convulsions are induced b}^ the child 
having eaten too much, or having partaken of improper 
or indigestible food, the stomach pump is naturally sug- 
gested as a certain means of relief. 

I did not have to wait long for an opportunity to test 
the practical working of my theory. I was sent for in 
great haste to see AYillie G.. aged 6. When I arrived at his 
bedside, I found him in profound coma, the eyes half open 
and turned back, froth exuding from the mouth, jaws 
tightly clenched, head thrown back, breath smelling very 
offensive and sour, face purple and breathing slow and 
stertorous. This condition had existed for half an hour, as 
I was informed. 



146 The Peoria Medical Monthly. 

Upon questioning his father about what he had eaten, 
and intimating that I believed that he had eaten some- 
thing that caused the spasm, he became quite angiy, and 
declared that it was impossible that anj'thing he had eaten 
could be the cause, as the boy had been with him the 
whole da}', and consequently could not have eaten any- 
thing deleterious without detection. 

It being impossible to give an emetic, and chloroform 
lieing only paliative, I determined to wash out his stomach. 
Always carrying with me a common soft rul^ber tube, a third 
of an inch in diameter, to use as tourniquet, stomach tube, or 
anything else that it could he used for. this tube was 
passed into the stomach, the mouth having been pried and 
held open with a knife-handle, and that viscus filled with 
warm water by the use of an ordinary enema syringe, 
wdiich was used to fill the tube, and then by keeping the 
external end of the tube below the surface of warm water 
in a basin, and raising the basin a foot or two above the 
level of the child's head, a very nice syphon was formed, 
through which the water flowed into the stomach. By 
lowering the basin the stomach was emptied. Continuing 
this washing back and forth for a few minutes relieved 
him enough to enable him to vomit, when up came a mass 
of apple peelings as large as my fist. With the appearance 
of the peelings the father's anger vanished, and the boj^'s 
muscles relaxed. Injecting a solution containing 10 grains 
of bromide of potassium and a few drops of tincture of 
opium through the tube into the stomach, to keep him 
quiet, and withdrawing the tulie, I took my departure, and 
the ))oy went to sleep to wake up in the morning all right, 
with the exception of some muscular soreness. 

On another occasion, where the parents declared that 
the child could not have eaten anything to cause the 
spasm, a large quantity of popcorn was dislodged with the 
happiest result. 

Again, I saAv a very Ijright little girl in spasms which I 
believe were as terrible as any I have ever witnessed, 
where nothing was brought up from the stomach but some 
oleander flowers. This case was seen in conjunction with 



Original Communications. 147 

Dr. M. F. Bassett, and we were compelled to administer our 
remedies for two days throagh the tube. She was nearly a 
week fully recovering, the delay being due likely to the 
absorption of poison from the oleander leaves, j^et the 
recovery was iDerfect and in everj^ way satisfactor3\ 

Of course I do not advise this treatment in all cases of 
spasm, but in those only where indigestion is a prominent 
factor. Where there is much sourness of the stomach, I 
am now in the habit of using a solution of bicarbonate of 
soda, to wash out the stomach first with, followed by pure 
water, then the sedatives are thrown into the stomach, and 
the tube withdrawn. 

The operation is very easily done, only requiring a 
piece of soft rubber tubing two or three feet long, and a 
syringe to fill the tube with. After the tube is once full a 
S3a'inge is unnecessary, and it is not absolutelj^ necessary 
in the begining, as the tube can be immersed in water 
until it is full and the external end doubled on itself and 
passed through a ring or tied so as to hold it in a kink; the 
other end can then be readily passed through the mouth 
into the stomach, after which, the outer end being held 
under water and lower than the stomach end, the kink is 
released and the vessel containing the water is raised above 
the stomach, the syphon is complete. This method of 
using a rubber tube for a syphon stomach pump was sug- 
gested by the late Dr. John T. Hodgen a good many j^ears 
ago in cases of poisoning, and most of the cases of 
convulsions in children are in reality cases of poisoning. 



Aet. II.— Best Methods in Practice. By Geo X. Jexxings, M. D., Tonica, 111. 

In the contest for business and mone}^ that most of us 
are engaged in. I have noticed that those who do the best 
work win; not necessarilj^ the most profound and learned, 
but the men who are up with the times — the most indus- 
trious, and have an eye for improvement in ways and 
means. 

Practitioners of medicine are no exception to this rule. 
The routine doctor who takes but one medical journal, and 



148 The Peoria Medical Monthly. 

confines himself to the identical formulas, medicines and 
instruments recommended by his college professors twenty 
years ago, is not the one to win patronage. 

I am called to treat a case of pneumonia, or rheuma- 
tism or cholera morbus — complaints that every doctor is 
presumed to know how to manage. It is not enough that 
the patient recovers; he would most likely do that without 
my aid; but I w^ant the recovery to be quick and the 
means used safe and agreeable. In short, I want to use 
the best methods; and this may make all the difference in 
the long run between success and failure. 

A physician who provides himself with the best appli- 
ances of his art, and who studies to make his prescriptions 
safe, and pleasant to the eye and taste, though the mortal- 
ity in his practice is no less than that of his routine 
neighbor, will secure the best patronage and take the most 
satisfaction in his business. 

The best methods are not confined to any particular 
branch or school of the profession, but may include much 
even of empiricism. Nothing, it is true, gives the practi- 
tioner of medicine so much satisfaction as having estab- 
lished facts and fixed rules to bear on every case that 
comes under his care; this is what distinguishes the 
educated physician from the mere empiric; jet not every 
case can be successfully treated on ''general principles;" 
and whether we are governed by the law of similars, or 
opposites, or of specifics, or by each as occasion requires, 
w^e shall often find ourselves ol)liged to fall back on expe- 
rience (our own or that of others) without regard to the 
why or wherefore. 

And this, it appears to me, is the most important 
function of the medical journal, namely: to furnish that 
interchange of experience, and that medium for the dis- 
cussion of w^ays and means which is necessary to develop 
the best methods in the practice of medicine. 

It is amazing how soon one finds himself far in the 
rear if he drops the periodical literature of the profession 
even for a short time. Two years of residence in southern 
California without a medical journal, placed the writer of 



Original Communications. 149 

this so far behind the times that he was ashamed to meet 
his medical brethren, when at the end of that time he 
resumed practice; and it was several years before the lost 
ground was recovered. 

Speaking in less general terms, it would be protitable 
to inquire, for instance, what is the best method of utili- 
zing the practical portions of our periodical literature for 
future reference? To what extent shall we patronize '"new 
remedies" and expensive iDharmaceutical compounds? To 
what extent dispense our own medicines? What atitude 
assume toward Homoeopathy? It is easier to ask questions 
than to answer them, but there are scores of such which 
occur to the medical man, beside the more important ones 
relating to the management of disease and remedies, the 
answer to which involves a consideration of methods. 

Hoping that what I have written may suggest thoughts 
for others to enlarge upon, I will abruptly leave the sub- 
ject with the possible contingency of resuming it at some 
future time more in detail. 



Akt. Ill — Treatment of Hemorrhoids by Forcible Dilation of the Sphincter 
and Hypodermic Injection of Ergotine. By X. Holton, M. D., Smitli- 
ville, 111. 

In April, 1S81, Mrs. G., aged 40 years, called me to see 
her as medical adviser; found her very anaemic, weak and 
emaciated, with a countenance of great anxiety. Upon 
inquiry as to the cause of her condition, she gave a history 
of hemorrhoids of 14 years duration, and daily hemor- 
rhages from them for a great part of the time, which of 
course clearly accounted for the great impoverishment of 
the blood, and the general deplorable condition in which I 
found her. Investigation showed numerous tumors in the 
rectum with a greatly relaxed condition of the mucous 
membrane of the lower bowel, and a deposit of fibrin at 
the anus and sphincter muscle, making such strong con- 
striction that it was with difficulty the index finger could 
be introduced for the purpose of investigation. 

She was told that treatment, to be of any value to her, 
must control the loss of blood; restore the bloody 



150 The Peoria Medical Monthly. 

remove the tumors, regulate the bowels, and restore the 
tone of the sj^stem generall5\ Regarding the constriction 
as an important factor, ])}' impeding the venous circulation 
in producing the hemorrhage. I advised her that the- anus 
would need dilating thoroughl}^ This might ])e done 
graduallj" by using dilutors, but my opinion was that rapid 
dilation by force would be the best course to pursue. She 
cheerfull}' consented to the latter course, and it was imme- 
diately put in practice b}^ administering ether as an anaes- 
thetic, and thoroughly dilating the anus by inserting the 
fingers into the rectum and using sufficient force to effect 
that result, and to my surprise, on account of her weak- 
ened condition, it required all my strength. A cold com- 
press was applied to the parts, and opiate administered, 
and she was directed to keep her bed for several days. 

The following pill was given morning, noon and night, 
commencing on the third day after the operation: 

g Stryclmia, 1-20 grain. 



Ferri siil.. 


1-20 grain. 


Ext. rhei., 


1% grains. 


Erirotine, 


1 srrain. 



M. Ft. pil. 

In a week I saw her and found there had been no 
bleeding since the operation, and the extreme pain she had 
been subject to on account of the protrusion of the tumors 
and mucous membrane of the bowels, when she had an 
evacuation from the liowels. together with strangulation 
of the protruded parts and inability to return them, was 
removed. At this visit finding everything favorable and 
that there had been but trifling inflammation from rough 
handling of the week before, 1 commenced the injection of 
the tumors with a watery solution of ergotine by the 
hypodermic syringe, operating upon three of them at this 
time. If this remedy has been used in this way and for 
such purpose before I am not aware of it, but the great 
relaxation and lack of tone of the whole mucous tract of 
the lower bowel suggested it to me in this case. The result 
has been so good that I call j^rofessional attention to it 
here, that others may make trial of it in similar cases if 
they have no better remedy. 

In a week another visit was made and three more 
tumors were operated upon, the two operations encircling 



Original Communications. 151 

^bout one-half the circumference of the diseased parts. 
At this visit she stated she felt better than she had in the 
whole time she had been suffering, and had had three na- 
tural evacuations from the bowels. A third operation 
upon the remaining tumors, in a week from the last, was 
supposed to be sufficient to completel}^ cure, but there be- 
ing some relaxation of the mucous membrane after three 
weeks, three more injections were made to make sure of 
complete cure. 

During the treatment she was directed to use a cool 
Sitz bath and injections into the vagina of quite warm 
water twice daily, the w^arm water injections to be followed 
by an injection of the following: 

I^ Acid carbolic, 2% draclims. 

Glycerine, 2}4 ounces. 

■ Tannin, 1 drachm. 

Aqua pura, 1J< pints. M. 

Ft. injectio. S. Use two ounces in vagina, retaining 
for a few minutes. 

This case must be regarded of importance for she had 
been treated by many doctors, some regular and some 
irregular, the greater part of the fourteen years, with a re- 
sult of constantly growing worse, till her case became one 
of great peril to her and constant suffering, and onl}^ be- 
cause her case had not been rationall}' investigated and 
treatment adopted sufficient to meet the indications. 



JArt. IV. — Facts Concerning Xasal Catarrh. By A. S. Core, M. D., Quincy, 
111. Continued from the July number. 

We will consider briefly the effect of obstruction in 
the nasal cavities upon the functions of adjacent organs 
which depend upon normally free and unobstructed nasal 
passage : First, olfaction ; second, vocalization ; third, 
respiration ; fourth, audition and the sequela? which follow 
w^here these passages become narrowed or closed. 

1. In the normal action of the olfactory function there 
is of necessity a free and complete interchange of the air 
in the nasal- cavities during each respiration, by which 
means the odoriferous particles are brought in contact with 



152 The Peoria Medical Monthly. 

the terminal filires of the olfactory nerve. A delicate odor 
is perceived by drawing air forcibly through the nasal i)as- 
sages charged with the odorous particles, but if by obstruc- 
tion the circulation of the air through the nose is cut off, 
the sense of smell is impaired. When disease invades this 
passage it extends by continuity of tissue to the olfactory 
region, and the olfactory cells become impaired by being 
bathed in the mucus secretions, cutting off the circulation 
of air through the nasal passages and impairing the sense 
of smell. 

2. In vocalization the normal or tortuous nasal pas- 
sages have the effect of increasing the resonance of the 
voice, but when an increased amount of secretion is poured 
into the passage by the secretions becoming so great, and 
in such quantity that it cannot be thrown off through the 
natural channel, it overflows and invades the pharynx 
and trickles down upon the delicate structure of the larynx, 
which, once in contact with these parts, the glutinous mu- 
cous acts as a foreign body and by its constant presence 
provokes a hard, raucous voice, without timbre or resonant 
qualities, and in common parlance, we " speak through the 
nose," as it is expressed: l)ut the facts are just the opposite,, 
for the passage being closed the sounding-board function 
of the pharynx and nasal cavities, on which so much of 
importance in vocalization depends, must necessarily be to 
a greater or less extent impaired and the voice rendered 
flat and raucous. 

3. In respiration the tortuous nasal passage is tO' 
warm the air and separate the fine particles of dust from 
it, forming a protection to the throat and lungs, as it were, 
by modifying the air we breathe, rendering it suitable for 
respiration. Many of the troubles of the pharynx, larynx 
and lungs are the dii-ect results of mouth breathing. The 
air should, in passing through the nasal cavities, be moist- 
ened, temperature elevated, freed from dust and foreign 
particles, and rendered uniform and suital^le for respira- 
tion; but when nasal respiration is impeded or cut off, 
there is a diminution in the air supply, and -manj' cases of 
dyspnoea, spasmodic asthma, and other conditions arise 
from the occlusion of the nasal cavities. 



Original CoMMumcATioifS. 153 

4. The ear must be in such relation to the nasal cav- 
ities as to admit of a continual communication of the ex- 
ternal air with the middle ear if perfect hearing is main- 
tained. The air can not be supplied to the tympanic cav- 
ity by any other route than through the nasal passages 
and eustachian tubes. The aural pressure is lessened in 
proportion to the degree of nasal obstruction. This tends 
to produce a partial vacuum in the middle ear b}^ cutting 
off the normal atmospheric pressure, so that in the act of 
swallowing the communication of air through the eus- 
tachian tubes is incomplete, owing to the obstruction. If 
the obstruction is great aural changes take place rapidly, 
giving rise to false hearing, distressing tinnitus, giddiness, 
severe earache, suppuration and gradually increasing deaf- 
ness. If it is only slight this goes on more slowly, some- 
times imperceptibly, and sooner or later the most serious 
functional and structural changes take jolace — that of col- 
lapse of the membranes, adhesive bands binding it to the 
posterior wall, causing an inactivity of the ossicular chain, 
and from this inactivity the delicate articulation becomes 
stiffened, impacted, and finally immovable from the altered 
tension. The tensor tympani muscle and ligament become 
so relaxed from disuse that the best efforts of the practi- 
tioner can not effect an improvement. 

The symptoms of nasal catarrh are those of frequent 
or more or less continuous obstruction of the nasal pas- 
sages, with a more or less copious secretion, mucous or 
muco-purulent in character, discharged from the passage 
posteriorly as well as anteriorly ; inabilit}^ to breathe 
through the nose; imj)airment of the sense of smell: a 
sensation of taking cold on slight unfavorable changes in 
the weather: weakness of the eyes, which become tired 
and painful on close application; a dull and languid feel- 
ing with persistent headache, causing one to be indisposed 
or incapacitated for mental work; inability to remove the 
nasal secretions ; hoarseness and disturbances of speech 
from the secretions constantly flowing back into the throat; 
asthma, deafness, and on arising in the morning with a 
feeling of fatigue, an unpleasant, bad taste in the mouth 
and a morning headache; and this only to be aggravated 



154 The Peoria Medical Monthly. 

i)y imprudent or accidental exposure to changes of tem- 
perature or local irritation. 

In regard to the diagnosis of a case in hand, one can 
only be made by the use of the nasal speculum and pharyn- 
geal mirro\Y. aided by a head mirror and artificial light. 
Whenever there is much accumulation of mucous or in- 
congruous masses in the nasal fossas, it must be cleaned 
away by blowing the nose, spraying, washing, or a mop of 
some kind, with which the inspissated secretions may be 
removed. With this the dilierent conditions can readily 
be seen and differentiated by their situation and appear- 
ance. The question that now arises, what must we do? 
depends on what the indications for treatment are, and 
may be formulated as follows: 

1. Attention to hygiene by removing all sources of 
irritation resulting from occupation, residence, etc., such 
as avoidance of inhalations of cold and hot air, dust and 
smoke; also of the ingestion of very cold or very hot 
strongly alcoholic or highlj' spiced foods and drinks. 
Smoking should be prohibited, but in the inveterate not 
altogether, because they will only obey for a short time 
and then smoke more excessively than before, and it is 
better to restrict them gradually to three cigars a day. 
Blowing the smoke through the nostrils is especially inju- 
rious, and one should insist on its discontinuance. Cigar- 
ettes are particularly injurious, and their use should be ab- 
solutely forbidden. 

2. Keep the parts clean b}' either gargling, spraying, 
or sj^ringing. using at first a solution of sodium chloride, 
sodium bicarb., potas. chlorate, one-half to one drachm to 
a pint of water, or Dobel's solution, which is: 

5 Acid f:irb., 8 grains. 

Sodte bicarl> 

Soda- biborate, aa. 16 grains. 
Glj'cerine, 1 (Hince. 

Afiua dist., 7 ounces. M. 

Gargling should not be done in the ordinary thought- 
less manner, which is little more than rinsing of the soft 
palate and oral contents, but be performed in such manner 
as to force the water into the upper pharynx and nose and 
even out of the anterior nares. I rely most upon the spray 



Original Communications, 155 

posteriorly, for by this means all parts can be reached and 
with bnt little danger, for in this way alone the mucosa of 
the naso-pharynx becomes rinsed and cleansed by the fluid; 
at the same time the muscles underneath the mucous 
membrane are made to contract and in turn promote the 
the functions of the muciparious glands. The Weber 
douche I consider as a relic of barbarism, as its use is 
attended with much danger. 

3. If there is obstruction to nasal breathing, either 
foreign bodies, pol5^pus, adenoid growths, hypertrophied 
glandular structure, remove it; and one of the best and 
most simple instruments for removing this, attended with 
but little or no danger, is the cold Ecraseur wire. In the 
use of this instrument traction must be made vevj slowly, 
stopping at short intervals in order to cause the slightest 
amount of hemorrhage. There is seldom much pain, but 
of course patients var}^ in their susceptibility to pain, and 
some may complain, but I consider them in the minority. 
The hemorrhage is trifling provided slow traction is made. 
It consists usually of one or two clots blown out upon the 
handkerchief. The method of treating these cases by the- 
use of the galvano-cautery is barbarous in the extreme, 
and does but little benefit to the patient, and there are cer- 
tain difficulties in the way of its use which render its ap- 
plication somewhat limited. It is difficult of manipula- 
tion. The amount of destruction of tissue that can be 
accomplished is very uncertain and not always where you 
want it. and moreover it is xevy painful. Were not these 
objections sufficient to exclude hot irons, or the actual cau- 
tery from the nasal cavity, there is one other objection in 
the form of danger attending its use, that is the danger of 
exciting an acute inflammation of an aggravated charac- 
ter, which may extend to the integument in the form of 
eiysipelas, besides all glandular structure is destroyed and 
a cicatrix lines the cavity, and you have a dry catarrh 
which no remedy will benefit. In the use of all escharotics 
the same aggravated conditions and complications may 
exist, but not to so great an extent. 

4. If there is hyperaucenia, use mild astringents and 
such constitutional treatment as is thought to be indicated. 



15G The Peoria Medical Monthly. 

As a local astringent remedy I consider arg., nit. insufla- 
tions, one of the best, but if the parts are ulcerated or 
granular, iodoform coml)ided with a sedative will answer 
best, and if atrophied, serpentaria or galangae are among 
the best stimulating remedies. Anj^ of these remedies can 
be combined with some bland powder, in strength varying 
from 1 to 10 per cent., and used b}^ insuflation. I believe 
that the same eftect can not be obtained by the same rem- 
edy in solution, whether introduced by the brush, spray or 
injection, because the irritation of the instrument will 
cause the constrictor of the pharynx to draw the mucous 
membrane into folds and parts cannot be reached at all 
with a solution, while portions not intended to be touched 
will receive too much and be thereby rendered iritable. 

5. Cease treatment as soon as contra-indicated and 
give nature an opportunity to complete the work. Many 
cases are perpetuated indefinitely by the continuation of 
remedies fired at random after the point of cure has been 
reached. 



^ont^potttUnre. 



Newport, Pa , July, 1882. 
Editor Peoria Medical MontJihj : 

Dear Sir — If space in j^our journal will allow, I would 
like to clinch a spike or two which Dr. CI. W. Carpenter 
drove in his article on typo-malarial fever, its cause, pre- 
vention and cure. 

I have not lived years in the profession, nor yet have 
I noted thousands of cases, Init the season 1 have spent in 
the profession has been one of careful observation, hard 
labor, and close study as regards malaria and its cause. 
My field of labor is one of the most pleasant which could 
be given to man in this wide world. Situated in Pennsyl- 
vania, along the " Blue Juniata," one of the tributaries of 
the Susquehanna, in the town of Newport, surrounded by 
mountains and on the bank of the rapid Juniata, the Indi- 
ana man would say. Lo, here is the place where malaria 
does not corrupt, and where chills do not break through 



Correspondence. 157 

and shake. But nevertheless we, too, are afflicted. Why ? 
Our town reaches from the river bank back over a high 
hill. Front street is along the shore, and in summer 
months have stagnant water close along the street. Yet 
those people who live there are no more exposed than 
those who live on the hill. I notice that the rock is about 
eighteen feet under the surface, and the wells (which are 
abundant) are twenty-five feet deep, leaving a pool in the 
rock of about five feet. The town is old, and a majority 
of the lots are a mass of privy pits, which constantly drain 
into the pools in the rock. 

As regards winds carrying the malaria miasm, I do not 
believe anything of the kind. That it is due to the drink- 
ing water of our town you will all agree, and if I had 
time I would prove it. 

As to the treatment, for which I am newly noted, I can 
give in a short space. I do not give quinine in drachm 
doses, nor whisky and calomel; for my experience teaches 
me that if a man has plenty of blood and that good, con- 
taining the requisite amount of red blood corpusles, that 
no matter where he lives he gets no malaria. I give a pill 
containing 1 grain each of quinidia, cinchona, ferri. sub. 
carb., pulv. blue mass and capsicum, four times a day. Or, 
I give cinchona, quinidia. each 1 grain; ferri. carb., capsi- 
cum, each 1 grain; leptandrin, pulv. rhubarb, each ^ grain, 
every three hours. And I often get good results from the 
following tonic: 

IJ Syr. ferri. iodidi, 2 ounces. 

Tr. cinchona, 2 ounces. 

Tr. nux vom., 3^ ounce. 

Ext. taraxacum, 1-12 ounce. 

One teaspoonful in half glass of water one hour before meals. 

I am of the opinion that if we used dialysed iron, 
which would not be injurious to the teeth, accordingly, it 
would cure more cases of malaria than quinine. 

Yours truly, Samuel W. Suloff, M. D. 



BusHNELL, III., July IS, 1882. 
Editor Peoria Medical Monthly: 

I would like to suggest, in the interest of physicians 
at large, that some measures be adopted to reach that pesty 



158 The Peoria Medical Monthly. 

class that secure the services of every physician within 
their reach as long as they can secure them for nothing, 
and then abuse every doctor who will no longer render his 
services without pay. It is well known that there is a 
class in every community who never try to pay a doctor- 
bill. They can usually afford tobacco, and other "luxu- 
ries,"' but can not pay those who administer to them in 
times of sickness. If doctors would keep lists of such 
persons as will not try to pay their bills, and publish the 
same or exchange lists with one another, and then make 
such persons pay in advance or let them go without aid, 
they might protect themselves against much fraud and 
abuse. It is high time something was done. Let us com- 
bine and see what can be done. 

R. A. PiNKLEY, M. D. 



gooK ^otiaisi. 



A Treatise on the Phj si<)l()*i:ital and Tlierapeiitical Action of the Sulphate of 
Qninine. By Otis Fredkrick Manson, M. D., Professor of Physiology and 
Pathology in the Medical College of Virginia. 12vo; Cloth; i)p. 1G4. J. B. 
Lippincott & Co.. Philadelphia, 1882. 

The contributions of Dr. Mansoii to the pathology 
and treatment of the various intermittent and remittent 
types of fevers, and the action of quinine as the therapeu- 
tic main-stay in them, have been mainly published, we be- 
lieve, through the volumes of the Virginia Medical Montlihj, 
and have elicited no little favorable comment, both at home 
and abroad. We are much pleased to see these valuable 
papers now In'ought into permanent form and made avail- 
able to all. The book liefore us contains everything that 
is known concerning this valuable remedy in a well di- 
gested form, and can not fail to interest and instruct. To 
the researches and conclusions of many authors he adds 
the experience aiid results of many years of close observa- 
tion and careful experimentation. There is nothing to 
criticize in his statements or conclusions, and but little in 
the mechanical part of the book. We believe, however, 
in a future edition that the italicizing of many words and 



Book Notices. 159 

sentences might be omitted. A iDrofusion of italics only 
destroys the force of their use, and also mars the beauty 
of the printed page. The division of the matter into sep- 
arate chapters and the addition of an index would materi- 
ally add to the volue of the book as a work for speedy ref- 
erence. We heartily recommend the book to our readers, 
and hope that others of the same kind, each treating 
briefly but exhaustively of a single subject, will follow. 

Reprints, Annouiiceinents, Etc. 

Double Irrigation and Drainage Tubes. 

Uteiine Dilatation by Elastic Force. 

The Cure of Hernia by the Antiseptic Use of Animal Ligature. By Henry 
O. Maecy, a. M., M. D., Boston. Reprinted from the transactions of the 
International Medical Congress, 1881. 

Hot Springs of Arkansas, and Their Therapeutical Indications. By J. T. 

Jelks, M. D. Reprint from Atlantic Medical Register. 

Plastic Splints in Surgery. By S-v^ixel X. Xelsox, A. B., M. D., Boston. Re- 
printed from the Annals of 'Anatomy and Sirrgert/, April, 1882. 

The Pi*actice of Gynecology in Ancient Times. By Edward W. Jexks, M. D., 
L. L. D., Chicago, pp. .52; Paper. Reprinted from Vol. VI, Gynecological 
Transactions. A very interesting article, containing much that is 
inaccessible to the majority of physicians. This "supposed modern 
speciality is shown to be but little in adqance of that of many centuries ago. 

Note on the Essential Psychic Signs of General Functional Neuratrophia or 
Neurasthenia. By C. H. HrfiHES, M. D., St. Louis. Reprinted from the 
Alienist and Neurologist, .July, 1883. 

Twenty-second Annual Announcement of the Bellevue Hospital Medical College, 
New York. 

Twenty-fourth Annual Announcement of the Chicago ^Medical College, Chicago. 

Annual Announcement of Trinity Medical School, Toronto. 

Fort}--sixth Annual Announcement of the Medical Department of the University 
of Louisville. 

First Annual Announcement of the College of Physicians and Surgeons, Chicago- 
Fortieth Annual .Vnnouncement of Rush Medical College. 
Annual Announcement of the Memphis Hospital Medical College. 

Seventy-fifth Annual Announcement of the College of Physicians and Surgeons, 

New York Cit\-. 
Annual Announcement of the Micliigan College of Medicine, Detroit, Mich. 

Annual Announcement of the ^Medical Department of the State Universitj- of 
Iowa. 

Annual Announcement and Catalogue of the Medical College of Indiana. 
Too Late for Review in This Nuniher. 

Mental Pathology and Therapeutics. By AV. Griesinger, M. D. AVood «fc Co., 
Publishers. 

"WTiat to Do in Ca.ses of Poisoning. By Wm. ^Murrell, M. D. George S. Davis, 
Publisher. 



IGO The Peoria Medical Monthly. 



The American Medical Association— Concluded. 

Dr. Davis, of Chicago, said that although he was a 
member of the committee which made its report the day 
before, upon reflection he was convinced that some amend- 
ments were required, and he therefore offered the follow- 
ing 

amendments: 

Resolved, That the interests of the association would be promoted by 
the publication of its transactions in a weekly medical journal under its 
own control, instead of in an annual volume as heretofore, provided it 
■could be done without involving pecuniary embarrassment, or so far en- 
grossing its funds as to prevent the annual encouragement of original 
investigation by its members. 

Resolved, That so much of the report of the committee on printing 
the transactions as relates to the increase of membership of this associa- 
tion by application from members of state and local societies be and the 
same is hereby approved. 

Resolved, That so much of the report of the committee in journaliz- 
ing the transactions of the association as relates to the appointment of a 
board of trustees, nine in number, and their duties, be and the same is 
hereby adopted, and that the president of the association should appoint 
a special committee of seven to recommend to this meeting of the associ- 
ation the names of nine members for election to constitute said board of 
trustees. 

Resolved, That the board of trustees so appointed be requested to 
agree upon a plan of a medical journal, to be called the Journal of the 
American Medical Association, and to- send circulars explaining such plan, 
and asking pledges of support by actual subscriptions, to the members of 
the medical profession throughout the whole country, and thereby ascer- 
tain as reliably as possible what degree of support the proposed journal 
can have as a basis for commencing its publication ; and that said board 
also proceed to ascertain and agree upon the best methods of publishing 
.said journal, the best editorial services it can secure to take charge of 
the work, and the best plan for its issue. 

Rej^olved, That said board of trustees be and are hereby instructed 
to retain under ail circuin.<tances, in whatever plans or contracts proposed 
for adoption, entire control over the advertising as well as other pages of 
the journal that is proposed to be established, and that said board report 
in full at the next meeting of this association, the plans upon which it 
has been able to agree, together with the response of the profession to its 
circular asking actual subscriptions to the proposed journal, and that the 
■constitutional amendments proposed by Dr. Packard last year be contin- 
ued upon the table until the report of the board of trustees is received 
and acted upon. 

Resolved, That the treasui-er of this association is hereby authorized 
to pay out of the funds in the treasury the necessary expenses of the 
board of trustees in ])rinting and distributing its circulars and in con- 
ducting its proper correspondence. 



Society Transactions. 161 

Resolved, That the committee of publication proceed to publish the 
proceedings and transactions of the present meeting in a volume as here- 
tofore, using all diligence to give it an early distribution to those entitled; 
to receive it. 

Dr. Davis supported his amendments in an earnest 
speech, and they were equally as earnestly seconded by 
Dr. Brodie, of Michigan, and were unanimously adopted. 

Subsequently the president appointed the following 
named delegates as a committee to appoint the board of 
trustees, in accordance with the resolutions, viz: Dr. L. A. 
Sayre, New York; Dr. J. M. Toner, District of Columbia; 
Dr. J. Foster Pratt, Michigan; Dr. R. J. Dunglison, Penn- 
sylvania; Dr. Robert Battey, Georgia; Dr. W. F. Peck, 
Iowa; Dr. H. 0. Marcy, Massachusetts. 

The trustees subsequently appointed by this commit- 
tee were as follows: 

For three years^ — Drs. Davis, Illinois; Moore, New 
York, and Toner, Washington, D. C. 

For two years — Drs. Campbell, Georgia; Packard,. 
Pennsylvania, and Connor, Michigan. 

For one year — Drs. Hooper, Arkansas; Garcelon^ 
Maine, and McMurtry, Kentucky. 

Dr. Toner, of Washington, submitted the report of the 
Committee on Necrology. It was referred to the Publica- 
tion Committee without reading. 

Dr. Davis, chairman of the Committee on "Atmos- 
pheric Conditions and their Relations to the Prevalence^ 
of Disease," made a report to the effect that observation, 
stations had been established at twelve cities, and' that the 
work is fully under way. It was 

Resolved, That the committee be continued, and that S500 in addi- 
tion to the unexpended balance of the previous appropriation be placed 
at its disposal. 

The following resolution was adopted: 

Resolved, That after the next annual meeting the permanent inter- 
ests of this association would be best promoted by again holding every 
second meeting in Washington, as its home on common national ground,, 
and not as invited guests, while each alternate meeting should be held in 
such section of the Union as would be most useful in pi-omoting the soci- 
ety organizations in all parts of our country. 

The report of the Nominating Committee was as fol-- 
lows: 

Place of meeting, Cleveland, Ohio. 

President — Dr. John L. Atlee, Pennsylvania. 

Vice-Presidents — Drs. E. Grissom, North Carolina; A. 
J. Stone, Minnesota; J. A. Octerlony, Kentucky; H. S.. 
Orms, California. 

Treasurer — Dr. R. J Dunglison, Pennsylvania. 



162 The Peoria Medical Monthly. 

Librarian — Dr. C. H. A. Kleinschmidt, Washington, 

D. C. 

Chairman of Committee of Arrangements — Dr. X. C. 
Scott, Cleveland, Ohio. 

Assistant Secretary — Dr. I. N. Hines, Cleveland, Ohio. 

Judicial Council — Drs. Davis, Illinois; J. M. Brown, U. 
S. N.: X. C. Scott. Ohio; M. Sexton, Indiana; N. C. Husted, 
New York; Wm. Lee, Maryland; J. E. Rives, West Vir- 
ginia. 

Practice of Medicine — Dr. J. H. Hollister, Illinois, 
Chairman: Dr. J. 0. Lee, Pennsylvania, Secretary. 

Surgery and Anatomy— Dr. W. F. Peck, Iowa, Chairman; 
Dr. P. F. Eve, Tennessee, Secretary. 

Obstetrics — Dr. J. K. Bartlett, Wisconsin, Chairman; 
O. A. Moses, Missouri, Secretary. 

Medical Jurisprudence and State Medicine — Dr. F. 
Pratt, Michigan, Chairman; Dr. T. L. Neal, Ohio, Secretary. 

Opthahnology, Otology and Laryngology — Dr. A. W. 
Calhoun, Georgia, Chairman; Dr. C. Seller, Pennsylvania, 
Secretary. 

Diseases of Children — Dr. R. Blount, Indiana, Chair- 
man; Dr. J. H. Sears, Texas, Secretary. 

Dentistry — Dr. D. H. (loodwillie, Xew York, Chairman; 
Dr. T. W. Brophy, Illinois, Secretary. 

Publication — Drs. W. B. Atkinson, A. Frincks, J. S. Cohen, 
F. AVoodbury, J. H. Packard, I. R, Dunglison and J. V. 
Shoemaker. 

The report was unanimously adopted. 



^m$to\H, 



The Physician of the Xovelist. 

The following extract from " Hot Plowshares," a novel 
by A. W. Tourgee, now printing in Oni- Continent, illus- 
trates the tact oftentimes necessary in the physician in 
cases of emergencies. 

A man and his son have been badly injured b}' a runa- 
way team; the family doctor and neighbors are in attend- 
ance, assisting the wife and mother. * * * * rp^^^ 
physician felt his pulse for the hundredth time, passed his 
hand over his face, pulled down the lids of one of his eyes 
and then of the other, peered into the unseeing orbs, and 
then drew a long breath of relief. 

" I guess it's over," he said. 

"You don't mean!" Mrs. Kortright exclaimed, in freu- 
zi ed tones. 



Periscope. 163 

"I guess lie will pull through," replied the physician, 
glancing keenly at her as he spoke, " but we mustn't spare 
any exertions till the circulation is better established. 
He's better, but he needs care. Everything depends on 
that now. Keep on rubbing him awhile longer, gentlemen. 
Are those flat-irons at his feet warm, Mrs. Kortright? 
Couldn't you get some more bottles of hot water to put 
about his limbs?" 

Mrs. Kortright became at once the obedient and care- 
ful nurse again. She left the room to obtain what was 
desired. When she had closed the door the physician's 
countenance relaxed. 

•' He's doing all right, gentlemen, but it won't do to let 
her know it just now. I've known her all her life. She's 
a mighty capable woman, no mistake about that; but this 
thing's been a little too much, and if she ain't let down 
easy there'll be another faint here. Just keep on till I tell 
you to stop. ' T won't do any harm, and will help her to 
pull up easy.*' =^ =^ * =!^ The doctor had been washing 
blood-stains from his hands, wiping his lancet, and turn- 
ing down his sleeves as he spoke. Mrs. Kortright entered 
the room as he concluded with a bottle in each hand wrap- 
ped in a towel. There was an anxious look in her face, 
but the strained, apprehensive expression had disappeared. 

"Can't you go and see Martin now?"' she asked, glanc- 
ing up at the doctor's face. 

"Certainly. Martha." he answered, with the familiarity 
of an old friend; ''but don't you have any trouble about 
him. If a boy ain't killed off-hand, you needn't be afraid 
but that he'll come out all right. Young bones are tough," 
lie added, in a jovial way. "Here, by the way." he contin- 
ued, pouring something into a glass and adding a little 
water, "3^ou just take this." The woman obeyed. "Now," 
said he, taking her by the arm and leading her to a large, 
old-fashioned rocking-chair, "just 3^ou sit down there and 
cry. You'll feel l)etter then. These gentlemen will take 
care of the 'Squire and I'll look after Martin." 

Mrs. Kortright sat down with a look of remonstrance 
in her eyes from which the tears were alreadj^ flowing. 
Ashamed to display her weakness, she threw her apron 
over her head and only her convulsive sobbing attested the 
relief which the tears brought. The physician nodded ap- 
proval and left the room. * « -5= =^ 



Siirg-ery of the Arteries. 

In concluding an excellent paper on the above named 
subject. Dr. R. A. Vance of Cleveland (Columbus Medical 
Journal), summarizes his matter as follows : 



164 The Peoria Medical Monthly. 

1. Bleeding from an accessible artery should be checked 
by twisting or tying both ends of the vessel. 

2. Moderate hemorrhage from one not readily reached, 
should be controlled by rest, position, local pressure, com- 
pression, etc. 

3. Severe hemorrhage from an artery not controllable 
b}^ pressure, etc., requires that the vessel be sought in the 
wound and both ends tied or twisted. 

(//). An important exception is to be noted in some 
cases of wounds of the hands or feet : the danger of dam- 
aging important structures may lead the surgeon to tie or 
twist the brachial or femoral rather than seek the w^ounded 
branches of the palmar or plantar arches. 

4. In fi'actures. complicated by wound or rupture of a 
large artery, the surgeon should at once cut into the swell- 
ing, turn out the clots, twist or ligate the central and peri- 
pheral ends of the arterial trunk. 

5. In pulsating tumors, following wounds or injuries of 
arteries, should rest, position, local pressure or general com- 
pression fail to check their growth or diminish their size, 
an operation should be performed, the tumor opened, clots 
removed and the vessel tied or twisted above and below 
the lesion. 

6. When a wound or injur}^ of an artery has led to ex- 
travasation, no operation should be performed, so long as 
rest, position, pressure or compression can restrain further 
hemorrhage, (a). An exception to this rule is to be noted 
in cases where the amount of blood in the tissues is so great 
as to threaten their integrity by gangrene, or wdiere, after 
checking further increase, the above measures fail to cause 
a diminution in the size of the tumor, despite the length of 
time they have been employed. 

7. It the extravasation caused by arterial wound or 
injury cannot be held in check and further hemorrhage 
prevented by position, rest, local jDressure or general com- 
pression, the tumor should at once be cut open, the clots 
removed, and the vessel tied or twisted above and below 
the point of injury. 



Dialysed Iron in the Treatment of Arsenical Poisoning-. 

It is not my intention to enter into an exhaustive pa- 
per on the subject of Arsenical Poisoning, but simply, as a 
duty, to lay before the profession what I consider a most 
valuable aid, the administration of dialysed iron. In the 
smelting of lead and silver ores, one of the worst features 
is the constant inhalation of arsenical fumes. When first 



Periscope. 165 

employed by the Alta Montana Company, to take charge of 
their hospital, a number of cases of arsenical poisoning 
came under my observation, and they were the more diffi- 
cult to treat on account of their complication with " lead- 
ing."' I tried the various remedies recommended for such 
cases, with but poor results. At times I felt that old say- 
ing, "Throw physic to the dogs,*' was but too true and 
applicable. At last I was led to try dialysed iron, and was 
met in all cases with most gratifying success, as is evi- 
denced by the following cases: 

Two carpenters were engaged in roofing a portion of 
the smelting building, and were in such a position that the 
wind carried the fumes into their faces. Some workmen 
below noticed one of the men swaying to and fro, and about 
ready to fall, while the other was laboring hard to reach 
the ground. They were helped to the hospital, and were 
suffering with severe pain in stomach and bowels, nausea, 
vomiting, vertigo, and with a profuse '• nose bleed," tremor 
in lower limbs, and almost prostration. A wineglassful of 
dialysed iron was given immediately. The nausea ceased, 
and at the end of one hour the men were able to walk to 
their cabins, carrying with them a bottle of the iron, to be 
taken in drachm doses every half hour. At the end of 
twenty-four hours they complained only of weakness, such 
as would result from a severe diarrhoea. The second day 
they resumed work, entirely free from all pain and effect^ 
of the arsenic. A number of men emploved about the 
smelting furnace, and especially in dipping the molten lead, 
have been apparently prostrated from the effects of the 
fumes, and were in every case relieved by dialysed iron. A 
mild purgative was given within twelve hours. I have 
recommended, and, indeed, insisted on every man 
who is exposed to the arsenical fumes taking a dose of the 
iron daily. The consequence has been that we have had 
but one case of poisoning needing hospital treatment, and 
this one insisted that his case was one of " indigestion and 
dyspepsia," and would take nothing till compelled to enter 
the hospital, where, under the administration of dialysed 
iron, he speedily recovered. 

In the past two years I think I am sate in saying that 
fully two hundred cases of arsenical poisoning have been 
cured in this camp by dialysed iron. I could cite any or 
all of them, with symptoms, treatment, etc., but I think it 
unnecessary as they so nearly resemble those already men- 
tioned; suffice it to say, that all experienced the nausea, 
griping, vomiting, muscular tremor, etc. I have given the 
iron in half-ounce doses three times daily, with no consti- 



166 The Peoria Medical Monthly. 

tutional disturbances whatever, even after ten and often 
twenty days administration. The teeth are not discolored, 
bowels not constipated and digestion not deranged. 

The men have learned its virtues and come regularly 
with " please fill my iron bottle again." They will not do 
without it any more than an Irishman will do without his 
" salts and senna." It has saved many a man his wages 
and many a day of sickness. In fact I feel convinced that 
this prei)aration is indispensable where men are liable to 
inhale the fumes of arsenic. 

Without a remedy of this kind I am satisfied no man, 
however strong, could inhale the fumes incident to smelt- 
ing, where the ores contain arsenic, and stand it more than 
three or four days. I can fully and confidently recommend 
this preparation of iron to the profession, and even to fore- 
men of smelting works where there is no physician, for it 
is harmless and invaluable. "An ounce of prevention is 
worth a pound of cure;" or a " pound of cure " is worth in- 
finitely more to a company than are hospitals full of men 
])oisoned with arsenic. Our hospital has been built, medi- 
cines bought, physicians and nurses paid, and accommoda- 
tions for thirt.}' beds provided, inside of two years, by a 
small monthly assessment on each miner and laborer em- 
ployed by the company, and all are satisfied; none more so 
than the smelter hands, who can and do get " a bottle of 
that iron " and keep at work. 

The preparation which I have used, and to the good 
effects of which I can testify, is Wyeth's, of Philadelphia. 
— .ui M. BuUan], M. D., in Medical and Surgical Beporter. 



Some Peculiar Effects of Ciiiclionia. 

Without special ambition to claim originalitj^, T wish 
to call the attention of the association to certain impor- 
tant, but hitherto unnoted, effects of the alkaloid cinchonia, 
which I deem valuable to the specialty. 

This agent has always occupied a modest place in the 
array of cinchona products, on account, especially, of its 
assumed inferiority as a febrifuge to quinia, but it has cer- 
tain remarkable qualities not possessed by those alkaloids 
to any noticeable extent, which seemed to have escaped 
general observation completely. Its tasteless quality, 
where unsalified, led me some years since to use it as an 
antiperiodic among children. Noticing certain peculiar 
effects, I made a study of its action on my own person. 
The observations then made I have since repeated many 
hundred times during a period of two years, and the effect 



Periscope. 167 

referred to I have found to be constant. They may be de- 
tailed in a few words: An hour after the ingestion of 
twenty grains, more or less, is made manifest a decided dis- 
turbance of the sympathetic system, as shown by cardiac 
weakness and irregularity, and a general sense of muscular 
debility with tremor, because quite marked; nausea is not 
infrequent. These effects may arise from any of the bark 
alkaloids and are not peculiar. At the same time paresis 
of visual accommodation appears and progresses to such 
an extent as to be almost complete in many instances at 
the end of the second hour; at this stage even the emme- 
tropic eye will require the aid of a number ten convex 
glass to properly distinguish objects at the normal near 
point. The ])aresis lasts eight or ten hours. It is not asso- 
ciated with any mydriatic effect in adults, but sometimes 
this condition is noticeable in children of delicate nervous 
organization. 

With these phenomena are associated primarily slight 
mental excitation, a sense of heat and blood-fulness in the 
head and upper parts of the body and some flushing of the 
skin. Later a relative pallor involves the entire surface ; 
the mucous membrane of the eyes, nose, mouth and throat 
becomes very dry and so continues for several hours. At 
the same time there is very decided obtusion of tactile sen- 
sibility. Stimulants, food and rest readily overcome the 
cardiac and muscular disturbance, but have no influence 
on the other named conditions. The foregoing observa- 
tions refer to effects upon adults. In young children within 
an hour after administration, a most decided erythema 
suddenly appears, notably about the head, but involving 
the entire surface. This appearance is exactly as in the 
third day of scarlet fever and just as then, the skin can be 
legibly written upon with a blunt point. This state of cu- 
taneous vaso-motor paresis is temporary and usually dis- 
appears within two hours, and is followed by a paleness 
more noticeable than in the adult, which is prolonged for 
several hours. 

The deduction from these observations is that cin- 
chonia, in additio;i to its tonic and antiperiodic effects, ex- 
erts special influences on the nervous apparatus cognate 
to those belonging to the alkaloid of belladonna, hyoscia- 
mus and stramonium, and should be correspondingly use- 
ful in those conditions in which this class of agents is 
indicated. 

Practically, I have found it eminently serviceable in 

febrile conditions associated with cerebro-spinal congestion 

, and in the more sthenic types of acute mania. The ordi- 



168 The Peoria Medical Monthl'^:. 

nary sedative effects of the bark alkaloids have superadded 
to them most marked vaso-motor influences, which result 
secondarily and permanently in an increase of tension and 
consecutive reduction of congestion. 

With these suggestions, 1 delegate to the physiologists 
further study of the niodus operandi of this neglected but 
important agent. — Alienist and Neurologist. 



The Difterciitial Staiiiing^ of Iffucleatetl Blood Corpuscles. 

It has been urged against the differential staining of 
histological structures that the i^rocess may induce an al- 
teration which may be mistaken for the normal condition. 
That this is in many cases true, is beyond question, but the- 
exceptions are far too numerous to justify it as a rule. 

For some years past 1 have used a process for th& 
double staining of nucleated blood corpuscles, which causes 
no alteration, except of course in color, and as the struc- 
ture can be seen much better in a semi-transparent than 
in a more perfectly transparent body, the corpuscles thus 
stained offer advantages for study which are not found in 
those left unstained. 

The fluids used for this purpose are two, which I shall 
designate as A. and B. Their formulas are as follows: 

A. 

Eosin, 5 grains. 

Distilled water, 4 drachms. 

Alcohol, 4 drachms. 

Dissolve the eosin in the water and add the alcohol. 

B. 

]Methyl analin green, 5 grains. 
Distilled water, 1 ounce. 

The blood should be spread upon the slide, by placing 
a drop upon one end and quickly drawing the smooth edge 
of another slide over it. This, if well done, will leave a 
single layer of corpuscles evenly spread over the central 
part of the slide. 

When the corpuscles on the slide ai*e thoroughly dry,. 
which will only require a few minutes, the slide should be 
'flooded' with stain A. 

This should be allowed to remain on for about three^ 
minutes, at the end of which time, it may be washed by 
gently waving l)ack and forth in a glass of clean water. 
Before it is allowed to dry, the corpuscles should again be 
flooded, this time with stain B. After two minutes exposure 
to this fluid, the slide should be washed, as before and set 



Pekiscope. 169 

away to dry. When dry, a drop of Canada balsam may be 
put upon the blood, a cover-^lass applied and the whole 
gently warmed until the balsam spreads out properly. 
When hard it may be finished the same as is usual with 
balsam mounts. 

If now examined with the microscope, the corpuscles 
will be found to be well stained with red, while the nuclei 
and " leucocytes " will be a bluish-green. 

The granular appearance wdiich is ordinarily seen in 
the nuclei, now shows with a vigor and sharpness which is 
difficult of description, while the whole corpuscle is as l^ril- 
liant as a newly cut ruby. 

In regard to the structure of the corpuscles, I can say 
but little. I have never had any difficulty whatever in 
seeing a distinct granular appearance in the necleus, pro- 
vided a first-class objective was used. But so far as a net- 
work is concerned, I have completely failed to see anything 
that could be called such, except when the objective used 
was improperly adjusted for thickness of cover or immersion 
fluid. In such cases the dots or granules "appear to run 
into lines," and a reticular structure may be interpreted. 
Even by the use of boracic acid I have completely failed to 
" bring out " the network. 

It has been held by some that the corpuscles are cov- 
ered by, or enclosed within, a "limiting membrane," but 
those who have endeavored to substantiate their claims — 
upon either side of the question — have failed as jet.—The 
Microscope. 

Surgical Expedients in Emergencies. 

In a paper read before the last meeting of the Penn- 
sylvania State Medical Society, Dr. R. J. Levis presented 
some original resources in the absence of ordinary means 
and appliances. 

The relief of an over-distended bladder he had effected 
by doubling a piece of common iron bell wire, and the 
blunt doubled end passed through the urethral tract, dis- 
tending it and allowing the urine to pass between the 
wires. 

A common rye-straw, with its end wrapped with either 
thread or yarn, or tipped with sealing wax, or the stem of 
a common clay tobacco pipe, are efficient su)3stitutes for the 
female catheter. 

Venesection can be made easy and certain, with even 
a dull and blunt pocket knife, by first transfixing the vein 
with a fine sewing needle. 

A number of ready and ingenious resources are given 
for the aiTcst of epistaxis and hemorrhage in general. A 



170 The Peoria Medical Monthly. 

good tenaculum is extemporized from a fish-hook tied to a 
pen-holder. A flannel bandage, cut bias, is sufficiently 
elastic to substitute the Esmarch bandage. 

Expedients for ready fracture dressings are given, one 
of the best of which is the material of common palm leaf 
fans, split into fragments and bandaged around the limb. 
For a ready fixed dressing the ordinary sand-paper, softened 
in warm water, is recommended, the paper, sand and glue 
giving, when dry, the requisite stiffness and body to the 
splint. 

Postural methods of treating fractures, as those in the 
vicinity of the joints, are referred to, and that of the clavicle, 
by a brief recumbent position. 

To open the mastoid cells in cases of abscess urgently 
threatening cerebral complication, he has effectually used 
a carpenter's gimlet. 

Rectal injection by a hydrostatic column, with a long 
tube, is referred to; and also the distension of the lower 
bowels, in cases of invagination and impaction, by carbonic 
acid gas and water from the ordinary mineral water bottle, 
or the syphon attached to a rectal tube. — Med. Summary. 



Suininer Complaint of Infants. 

Cholera infantum is often used as a synonym for sum- 
mer complaint, but the two terms are not interchangeable; 
the former is the name of a distinct and well characterized 
disease, the latter is a popular title for a group of diseases. 
Not one case in ten of summer complaint is truly an instance 
of cholera infantum, although summer complaint is com- 
monly made to include all cases of bowel disorder occurring 
in children at this season of the year. Most cases, however, 
of so-called summer complaint are serous diarrhoea, or 
gastro-enteritis, and entero-colitis, in which many causes 
are concerned. Especially do we find bad hygiene, poor 
ventilation, unhealthy surroundings, and errors in diet, 
such as eating unwholesome food, spoiled or green fruit; or, 
in infants, the dirty feeding bottle and bad milk are fruit- 
ful factors of this form of disease, A child that has just 
managed to get along for many weeks under an improper 
diet and the consequent chronic gastric disorder, finds itself 
unable to continue the struggle for existence, when to the 
burdens it already has borne is added the debilitating influ- 
ence of hot weather. Sometimes it is the nursing mother 
that is at fault, because, fatigued and over-heated, she 
gives her child the breast to keep it from fretting, without 
reflecting that her feverish milk is unwholesome; and then 
expresses surprise that her milk disagrees with the child. 



Periscope. 171 

As a rule, however, it is the bottle-fed child that furnishes 
the victim to summer complaint, because its milk is some- 
times hot and sometimes cold, occasionally too sweet, fre- 
quently nearly sour, rarely fresh, and never uniform, nor 
scarcely ever prepared twice exactly alike. 

Cholera infantum, on the other hand, is analogous to, 
if not identical with, sporadic or British cholera in adults. 
It is due to a specific cause, is decidedly epidemic, is not 
limited to hot weather, nor caused by it, nor are the symp- 
toms those of insolation or thermic fever. It may come on 
suddenly in an apparently healthy child, producing violent 
symptoms without prodromata; the child may go to bed 
well and have an attack during the night, quite independ- 
ently of any indiscretion of eating, or other known cause. 
It is believed, however, that children suffering with chronic 
gastro-intestinal disorder are more subject to its attack and 
have less powers of resistance. 

As regards treatment, cases of cholera infantum require 
prompt and vigorous therapeutic measures. The hot bath 
may be needed to avert the imminent collapse; brandy and 
ice to check the vomiting, and the use of opium, by the 
mouth or rectum, to relieve the tenesmus and profuse 
purging, which is of a w^atery character, and without the 
fecal odor or color. 

Summer complaint, whether in the form of gastro- 
intestinal catarrh or colitis, presents a different clinical 
picture and affords more time and scope for therapeutics. 
The child has had a diarrhoea for some time, perhaps 
irregularly, is getting worse, and its food does not agree 
with its stomach and is often vomited. The discharges are 
frequent, clay-colored or yellow% according to the amount 
of bile contained, and if the large bow^el is inflamed there 
is more or less blood and mucus, or the discharge may con- 
tain some hsematin, and assume a bright green color on 
exposure to the air. There is more tenesmus than in 
cholera infantum, and the child is less prostrated by the 
disease, which may last for weeks, getting better or worse, 
according to the fact whether vigilance is exercised in 
regard to the diet or some new indiscretion is committed. 
The child's skin is more or less feverish, while in cholera 
the surface is cold. 

From the fact that both classes of cases occur during the 
hot w^eather, it has been inferred that summer complaint 
is a form of insolation or thermic fever, and to be ti-eated 
by ice. This is unphilosophical in theory and fatal in prac- 
tice. Dr. N. S. Davis, in his communication to the 
Children's Section of the American Medical Association, at 



172 The Peoria Medical Monthly. 

its last meeting, on " Serous Diarrhoea and Cholera Morbus 
in Infancy and Childhood, and the Best Means of Lessening 
the Mortality from these Affections," presented a judicious 
and timel}^ contribution to the subject, and pointed out the 
proper use of water by the sponge bath, night and morning, 
as an invigorator of the nervous system — not as a means of 
extracting heat, but to excite reaction and improve the 
physical condition, so as to enable the child the better to 
resist heat. He states that an examination of the statistics 
of several large cities shows a ratio of only about five deaths 
from cholera infantum annually for every 10,000 inhabitans 
in San Francisco, seven in New Orleans, twenty-five in 
Boston, and thirty in Chicago, and observes that ''There 
must therefore be some efficient cause not common in all 
large cities," and proceeds to explain on meteorological 
and physical grounds. We think an explanation nearer at 
hand is to be found in the fact that in southern cities the 
houses are built for hot weather, and are therefore better 
ventilated, that the children are clad in lighter clothing, 
that there is a good supply of healthy milk for babes from 
negress w^et nurses, and finally, that there is a much smaller 
proportion of the population living in squalor and filth in 
New Orleans than in Boston or Chicago. 

To the usual recommendations for hygienic treatment, 
change of air, proper clothing, carefully regulated diet, and 
the tonic eftects of the daily sponge bath, we would add 
that in the medical management of the case astringents 
and opiates should be sparingly used, and only after clear- 
ing out of the intestinal tract any irritating material by 
small doses of calomel or gray powder followed by castor 
oil (or salad oil in infants), and the use of starch enemata, 
medicated with chloral and morphia. The patient may 
drink cold water in small quantities as often as desired; it 
is better to use a weak solution of arrowroot, or the white 
of an agg diffused in water, than ice water, and the diet 
restricted to boiled milk, and only a limited amount of 
this. Powders of pepsin and bismuth are often highly 
serviceable, but in many cases brandy given in liberal doses 
will prove the best means of averting the tendenc}^ to fatal 
exhaustion. — Editorial in College and Clinical Becord. 



Fractured Patella. 



In a note to the British Medical Journal, Mr. Christopher 
Heath agrees with Hutchinson that in fracture of the pa- 
tella separation of the fragments depends on effusion, 
either of blood or synovia, or a mixture of both. He does 



Periscope. 175 

not hesitate to aspirate the knee-joint in cases both of frac- 
tured patella and injury to the joint without fracture. 
Having emptied the joint, or if the patient is seen before 
effusion takes place, a plaster of paris bandage over an en- 
velope of cotton wadding is applied and the patient made 
to get about as soon as the plaster is dry. Mr. Heath claims 
better results by this method than follows the old practice 
of keeping the patient in bed and not touching the bone 
for six weeks. A distinctly ligamentous union is more 
satisfactory than close or so-called bony union. — Lou v. Med.^ 
News. 

Blood- Letting- in Metritis. 

Dr. J. Direra {Gfacefa Medica Catalana, May, 1882) claims'- 
that scarification is a valuable method of treatment in 
metritis and areolar hyperplasia. The time to begin the 
treatment is just after the menstrual epoch. Scarification' 
should be performed on alternate days. The object is not 
so much to let out blood as to prick the gorged capillaries 
causing their contraction followed by uterine contraction. 
He concludes first, that scarification is a potent measure in 
the treatment of chonic metritis ; in acute metritis it is 
also of value. Second : Local blood-letting is always indi- 
cated, general rarely. Third : Direct blood-letting from, 
the uterine cervix, is a most valuable local means.. 
Fourth : Scarification is best adapted to meet this indica- 
tion. Fifth : In the second period of chronic metritis, it 
is, at best, useless. Sixth : Intra-uterine medication is a 
good adjuvant. Seventh : A pointed instrument is prefer- 
able to any other means. Eighth : Loss of blood is the 
chief agent in producing the beneficial results. Ninth : 
The scarification should be frequently repeated. — Chicago' 
Medical Bevieir. 



Epitlielioma — Clilor. Potassium. 

It ':'oes not seem to be generally known that excellent 
results have been obtained recently from the application, 
of powdered chlorate of potassium to epithelioma. The 
surface of the ulcer should be well cleansed and finely; 
powdered chlorate thickly dusted on it, and be allowed to 
remain till the next dressing. The application may be 
made twice a day, the surface being cleaned before re- 
applying the powder. This treatment is said to relieve the 
pain, to change the character of the morbid process and 
promote healing. The same application may be used in 
chancre, chancroid, and in unhealthy ulcerations generally,.. 
and it has the merit of safety. — Mecl. Netvs. 



174 The Peoria Medical Monthly. 

Foreign Bodies in the Air Passages. 

Dr. Weist {Medical Record, July 12, 1SS2), at a meeting 
'Of the American Surgical Association, read a paper on the 
aliove subject. The following conclusions were submitted 
by him : 

First — When a foreign l)ody is lodged either in the 
larynx, trachea, or ])ronchia, the use of emetics, errhines, 
or similar means, should not be employed, as they increase 
the sufferings of the patient, and do not improve his 
^chances of recovery. 

Second — Inversions of the body and succussion are dan- 
g-erous, and should not be practiced unless the windpipe 
has been previously opened. 

Third — The presence simply of a foreign body in the 
larynx, trachea, or bronchia, does not make bronchotomy 
necessary. 

Fourth — While a foreign body causes no dangerous 
-symptoms, bronchotomy should not be performed. 

Fifth — While a foreign body remains fixed in the 
trachea or bronchia, as a general rule bronchotomy should 
not be practised. 

Sixth — When symptoms of suffocation are present, or 
occur at frequent intervals, bronchotomy should be re- 
sorted to without delay. 

Seventh — When the foreign body is lodged in the 
larynx, there being no paroxysms or strangulation, but an 
increasing difficulty in respiration, from oedema, inflamma- 
tion or bronchotomy is demanded. 

Eighth — When the body is movable in the trachea, 
and excites frequent attacks of strangulation, bronchotomy 
should be performed. 

The Social Position of the Doctor. 

Lay testimony concerning the social position of the 
doctor in England confirms the statement of Dr. Fothergill, 
that it is a very poor one. The London correspondent of 
Trihio/e (quoted in the Medical Becord July 29, 1882.) com- 
menting upon the matter, tells the following anecdote : 
''The wife of a fashionable physician living in May fair is 
responsible for this story. She was in want of a cook and 
resorted to the advertising columns of the Times. One of 
the advertisers to whom she wrote entered the house, it 
would appear, without noticing the brass plate on the door, 
which here announces the doctor's residence, but heard on 
her way up stairs into what manner of dwelling she had been 
beguiled. She sailed into the drawing-room, and, without 
preface' of any sort, delivered her soul thus : ' If you please, 



Periscope. • 1 75 

mum, I said parfcickler in my advertisement that I want a 
situation in a gentleman's family, and I won't trouble j^ou 
no further.' And sailed out again." The worst of it is 
that, according to New York i^hysicians who have often 
visited London, the social position of the English doctor is 
low because it deserves to be. He is in most cases the 
worst kind of a middle-class Philistine. — Chicago Medical 
Revieiv. 

Infantile Convulsions. 

The adopted and regular treatment of M. Jules Simon, 
of the Hospital des Enfantes Malades for infantile convul- 
sions is as follov\^s : On arrival the first thing he orders is 
an injection of salt and water, salad oil, or glycerine, or 
honey, which he administers himself, as he has too often 
observed that the parents or the nurse have already lost 
their wits. If the teeth can be opened sufficiently a vomi- 
tive is given which clears the stomach of any food that 
could not be digested — the most frequent causes of con- 
vulsions. However, 'the attack continues but soon ceases 
on ap23l3ang a handkerchief, on which a few drops of chlo- 
roform are poured, to the mouth, which the child inhales 
largely. If convulsions reappear the anaesthetic is renewed, 
and the child is placed in a mustard bath for a few minutes, 
and then wiped dry and placed on his bed properly 
wrapped. Chloroform might be again administered if, after 
an interval, the child was seized again, and before leaving 
M. Simon prescribes a four ounce potion containing sixteen 
grains of bromide potassium, one grain of musk, and a i^ro- 
portional preparation of opium, for he does not believe that 
the brain is congested in these attacks, it is rather excited, 
and the opium acts as a sedative. A teaspoonful of the 
mixture is given several times a day. On the following 
days the child is generally restless and irritable and ready 
to be attacked again, but a small blister aliout an inch 
square is applied to the back of the neck and left on about 
three hours, when it is replaced by a poultice of linseed 
meal and gives most satisfactory results. M. Simon, in 
terminating, says "such is the treatment that I have insti- 
tuted in my practice of every day.'' — Medical Press and Cir- 
cular. 

Mercury Used in Dentistry. 

Dr. Eugene S. Talbot, of Chicago, in American Medical 
Association, read a paper on "The Injurious Effects of Mer- 
cury used as in Dentistry." The paper was confined to the 
use of amalgam fillings in natural teeth. 

There can no longer be doubt that amalgam fillings in 



176 The Peoria Medical Monthly. 

teeth will sooner or later produce mercurial poisoning.. 
dire efiects of this metal are not always seen immediately 
after the fillings are inserted, years sometimes elapsing be- 
fore the injurious eftects were felt and noticed. 

The history of two well-marked .cases w^ere here given 
l)y Dr. Tal])ot, the persons having called upon him for 
treatment. The amalgam fillings were removed, and 
gutta percha temporarily sul)stituted, these in turn being 
replaced with gold, after which all symptoms of mercurial 
poisoning disappeared. A detailed account of a series of 
experiments made by him were then presented, the con- 
clusions and results being as follows: 

1st. Mercurial vapor is given off from amalgam fill- 
ings at all ages and from all varieties, even from fillings 
sixteen years old, the vaporization being sufficient to re- 
spond to chemical tests. 

2d. Minute doses of mercury, if taken internally three 
times a day, are capable of producing decided effects. 

3d. Mercury when inhaled into the lungs is far more 
active than when taken into the stomach. 

4th. If small doses taken into the stomach occasion- 
ally are capable of producing marked efiects, and the 
vapor is much more active than the solid prepararions of 
the metal, is it not a necessary consequence that amalgam 
fillings which are constantly giving oil' mercurial fumes to- 
be inhaled into the lungs, not a few times daily, but always. 
Avithout cessation, day or night, is it not a necessary conse- 
quence that in many sensitive persons such fillings must 
produce deleterious efiects ? 

5th. When tons of this material are consumed annu- 
ally, is it not credible that many constitutions are affected? 

6th. Physicians in treating dyspeptics, anemics and- 
persons sufi'ering from nervous debility, would do well to 
examing the mouths of patients and know if artificial 
teeth on red rub]:)er or fillings of natural teeth have in their 
composition mercury or any of its compounds. — Detroit 
Clin ic. 

Diphtheritic Coiijiiuctivitis— Sulphate of Qiiiniue. 

Dr. John Tweedy (Lcnicef) has had very good results- 
from the local application of quinine sulphate to the con- 
junctiva in diphtheritic conjunctivitis. He uses a solution 
of four grains of sulphate of quinine to an ounce of water. 
The conjunctiva? are washed three times a day with this 
solution after cooling it with ice. He is inclined to believe 
that the quinine exerts not only a local but a constitutional 
Giiect.—Chica(/o Med. liev. 



Periscope. 177 

Treatment of Cicatrices. 

Una has found (abstract in Vieytelj. fur Derm, unci Syph., 
Heft 2 and 3, 1S81, p. 499), the cicatrices of small-pox, and 
after ulceration, much improved in appearance by daily 
rubbing with fine sand. A small sponge, soaked with soap 
lather, is dipped in the powder collected from the debris 
of marble, and is then steadily rubbed over the cicatrix. 
The resulting improvement is attributed to the stimulating 
effect of the mechanical irritation. — London Med. Record. 



Glonoiiie in Cardiac Disease. 

Dr. W. E. Green (Practitioner), claims that glonoine 
Tanks second only to digitalis in the treatment of cardiac 
•disease. He generally gives it in minim doses of a one per 
cent, alcoholic solution. It is especially indicated in an- 
gina pectoris and weak dilated and fatty heart. In the 
latter it gives relief by reducing arterial tension and thus 
lessening the amount of work the heart has to do. The 
drug may at times be advantageously combined with digi- 
talis. ^ It produces a sense of fullness in the head and a 
general feeling of warmth. — Chicago Med. Rev. 



Cholera Pills. 



The following prescription was recommended highly 
by the late Dr. Chas. Meigs as an anaesthetic or cholera 
pill : 

5 Morph. sulpli., 13 grains. 

Camphorge, 20 grains. 

01. cajeputi, 10 drops. 
Tragacanth, 5 grains. 

Ext. gent., 15 gi-ains. 
Syrp. acacise, q. s. 

M. Ft. Mass. et div. pil. No. 100.— Med. Bulletin. 



Neuralgia . 

Dr. David L. Wallace, of Newark, N. J., recommends 
the following ointment for neuralgia through the columns 
of the Medical Record . 

5 Veratrise, 4 grains. 

Morphise, 6 grains. 

Tr. Aconit. rad., 1% drachms. 

Vaselinse, 1 ounce. 

M. Sig. To be applied to painful part every fifteen 
minutes. 



ti3:ei 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Edilor and Publisher, 

2 04 South- Jefferson Street, .... PEORIA, ILL. 

*** All exchanges, books for review, and communicatiuns must be addressed to the 
Editor and Publisher. 

H:**The publication day of this journal is on or ahout the 10th of each month 
***To subscribers! A pencil marlt at this place indicates that tlie lime of your sub- 
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C^tUtoilJtl ^t\mx\mt\\\. 



A Deadly Toy. 

A reference to the files of any. large daily paper for 
July, ISSO, will reveal the fact that deaths from tetanus 
were comparatively frequent at that time. The subject 
created some slight comment, but was soon forgotten. 

The month of July, ISSl, furnished a very much larger 
number of fatal cases, estimated roughly at upwards of 150. 
The cause of the unexampled prevalence of this horrible 
disease was then for the first time generally discussed, and 
it was found that almost every case followed a wound 
(from the most trivial to those of considerable magnitude) 
produced by a toy pistol introduced to the trade a year 
before. Still, with rare exceptions, to be hereafter men- 
tioned, no further attention was paid either by the profes- 
sion or authorities to stopping the work of this murderous 
toy. 

Some thirty-seven deaths were reported from this cause 
in the city of Baltimore in 1881, on account of which the 
City Council immediately enacted an ordinance strictly 
forbidding the manufacture, sale or use of these toys. 

We have been informed that the Minnesota Legislature 
also passed similar laws. 

During the month of July just closed, almost every 
paper has contained reports of fatal cases occurring in 
every part of the country. Basing our calculations upon 



Editorial Department, 179t* 

these newsjDaper reports, the number of fatal cases since ^ 
July 1, 1882, has considerably exceeded 250, and the cause 
given in every instance has been the toy pistol. 

Baltimore, however, thanks to the wise precautions of 
her council, has reported but a single case, instead of the 
thirty-seven of a year ago; and but two, so far as known 
to us, have been reported in Minnesota. 

It is singular that so large a number of cases of tetanus 
occurring within so short a period of time, and proceeding 
from so certain a cause, should not have received more 
attention from the medical profession; but we have looked 
in vain among our exchanges to see the subject mentioned. 

There are two forms of this deadly toy. both of which 
seem from the press reports to be equally dangerous — those 
exploding a paper wafer and those exploding a blank 
cartridge. The paper wafers contain fulminate of mercury 
and chlorate of potassium, while the blank cartridges also 
contain a very small amount of fulminating compound.. 
This being the case, it is nearly safe to suppose that it is 
the mercurial salt which does the mischief, especially since 
it is stated that such compounds introduced directly into 
the circulation are active poisons. 

But it was not our intention to discuss the causes of 
the tetanus, our idea being to arouse the profession, and 
through them the people, to the necessity of prevention — • 
which in this case is easy of accomplishment. 

The subject should be so forcibly brought, before every 
City Council and legislative body in the country that united 
action, prohibitory of the sale or use of these toys, would 
be secured, and the country spared the lives of several 
hundred each year. 



Burial Permits. 



We are in receipt of a letter from the Secretary of the 
State Board of Health, in which he requests us to bring 
this matter before our readers. 

At a late meeting of the Board a resolution was adopted 
which recommends that all cities and towns in this State 
having a population of 1,000 or over, enact an ordinance^ 



180 The Peoria Medical Monthly. 

requiring a burial permit as a condition precedent to inter- 
ment or removal of a body from the city or town. 

Similar laws have been in force in several cities in 
this State for some time, and their workings have been 
very satisfactory wherever they have been enforced. 

The Secretary summarizes the l)enefits to be derived 
from such laws as follows: 

First. — It will be of value in securing fuller, more 
accurate, and more readily available knowledge of the 
causes of death — a knowledge which is absolutely necessary 
to the profitable application of efforts for the preservation 
of health, the limitation of disease and the prolongation of 
human life. 

Secoi/d. — It will be of value in the protection of life 
against criminal violence, by facilitating the detection of 
such violence through preventing the burial of victims of 
homicide, abortion, poisoning, etc., without proper investi- 
gation. 

Third. — It will be of value in the protection of prop- 
erty interests, by making the facts pertaining to a death 
and burial matters of record which may be useful in pro- 
bating wills, settling estates, determining heirships, per- 
fecting letters, adjusting life insurance and kindred matters. 

The form of such an ordinance has been prepared under 
the direction of the Board, and a copy may be had by 
applying to the Secretary, Dr. Ranch, at Springfield, 111. 

The only addition to this form which we would pro- 
pose, is that the physician be paid the sum of ten or 
fifteen cents for every report so handed in to the health 
officer. It is unjust that physicians l)e required to fill up 
statistical papers without remuneration. We would like 
to see the State Board of Health agitate this matter; or, at 
least, put themselves on record concerning it. 

We are of the opinion that the proposed ordinance 
cannot be enforced unless a certain sum be specified as pay- 
ment for the time required in making out the certificates 
upon which the burial permits may be based. 

Notes and Coiuiueiits. 

National Board of IlealfJi Bulletin suspended from lack 
-of funds. J 

Dr. W. H. Mussey, of Cincinnati, died of apoplexy 
August 1st. 



Editorial Department. 181 

Cholera iu Japan, parts of India and Western Asia, and 
is gradually working westward. 

Dr. D. W. Cheever succeeds Dr. Bigelow as Professor 
of Surgery in Harvard University. 

Small-pox about extinct in Chicago, but spreading in 
Baltimore and still to be found in Cincinnati. 

Four hundred cases of yellow fever at Metamoras, 
Mexico, 100 at Laredo, Texas, and some in Brownsville. 

Dr. Moses Gunn has been elected one of the Vice-Presi- 
dents of the American Surgical Association for the coming 
year. 

Frightful mortality among children in New York and 
Chicago, due to extreme heat and poor sanitary arrange- 
ments. 

The Northwestern Lancet has been enlarged to twelve 
pages, semi-monthly, and the editorial corps increased to 
something near a dozen. 

Billroth having declined to leave Vienna, Prof. Volk- 
mann, of Halle, has been chosen as Langenbeck's successor 
at the University of Berlin. 

"There are people cynical enough to believe the world 
IS wanting in gratitude. They never saw an undertaker 
hover around a doctor." — Harper. 

Dr. John L. Atlee, the new President of the American 
Medical Association, is eighty-three years of age, but is as 
sprightly and active as most men at sixty. 

Dr. John B. Hamilton, Surgeon-General of the Marine 
Hospital Service, has been appointed one of the faculty of 
the Columbia National College, Washington, D. C. 

Dr. 0. B. Will has returned from a ten days' sojourn in 
Kansas, whither he was called to operate for lacerated cer- 
vix. The results were highly satisfactory to both operator 
and patient. 

The Michigan Med. News does us the honor to print 
entire the page of "Therapeutic Notes" from our July 
number. Unlike some of our copyists, the News is always 
careful to give full credit for its clippings. 



182 The Peoria Medical Monthly. 

" Der Lord sees all tings, und it vas a cousoling thought 
to some of der dochters dot der Lord don'd vill tell." — 
Carl Pretzel. The Lancet and Clinic in a moment of remorse 
and possible consciousness of its truth exclaims, "dot's 
shust so." 

A French newspaper advertisement reads: "Wanted! 
a distinguished healthy-looking man to be 'cured patient' 
in a doctor's office." Some Yankee must be teaching the 
French doctors how to succeed in business. 

We have received a copy of the Sanitanj News, edited 
and published by Drs. R. C. S. and C. A. L. Reed, at Cincin- 
nati. Its contents are unusuall}^ interesting and instructive 
both to the practitioner and the lay reader. The country 
needs more journals of this kind. We will be pleased to 
exchange. 

We notice that a paper on " Laceration of the Female 
Perineum," has appeared among the original articles in at 
least three of our exchanges. The habit some winters have 
of sending manuscript copy of the same article to several 
journals at the same time is a fraud upon the journals, and 
should be severely put down. 

Just because, in a mood of admiration for "the pig 
city of our State," we exclaimed, "Great is Chicago," the 
Lancet and Clinic accuses us of being the prophet of Chi- 
cago. Too much honor, we assure you, and a position to 
which we do not aspire. Besides, we don't know what you 
mean, Bro. L. and C. Please explain. 

The first instance where physicians are mentioned in 
the Bible is II Chronicles xvi: 12, "And Asa, in the thirty- 
ninth year of his reign, was diseased in his feet until the 
disease was exceedingly great; yet in his disease he sought 
not the Lord but the physicians." The compiler coolly 
adds, as though a natural consequence: "And Asa slept 
with his fathers." 

The Chicago Medical Review is authority for the state- 
ment that Dr. S. V. Clevenger has been elected Professor 
of Artistic Anatomy in the Chicago Academy of Fine Arts. 
Well, well! What next? The time seems to be rapidly 



Editorial Departmekt. 183 

approaching when the simple title of 'doctor' will be as 
rare as was in olden times the much-coveted one of Pro- 
fessor. What is "Artistic Anatomy," anyway? 

Georgie M., aged four, asked why his little cousin, 
Sarah, was being taken to church, and on being answered 
that she was to be baptized, said: "'I want to be baptized 
too.'* His mother replied that he had been baptized 
already. •'Yes, I know," said he, ''hut it didn't taheT 
Georgie had been vaccinated unsuccessfully a while before, 
and got baptism and vaccination mixed. Fact. 

The Kansas City JRevietv of Science and Industry for 
July contains a very able and exhaustive paper on '' Torna- 
does; Their Special Characteristics and Dangers,"' by Ser- 
geant John P. Finley, of the Signal Service. The Beciew 
is one of the best scientific journals published in this coun- 
try, and is a credit to this flourishing western city. 

The two medical colleges of St. Joseph, Mo., viz: The 
St. Joseph Hospital Medical College, and the College of 
Physicians and Surgeons, have united under the name of 
the St. Joseph Medical College. This is a step that de- 
serves great praise and one that could be followed in other 
cities with benefit to the colleges and no harm to the med- 
ical profession. Let us have more unions. 

A writer in the Ft. Wayne Journal of Medical Sciences 
gives a prescription for gonorrhoea, containing: Copaibse, 
ol. santali flavi, ol. cubebee, spts. etheris nitrosi, spts. juni- 
peri rect, tr. belladonnse. tr. digitalis, liquor ammoni- 
acetatis, liquor potassse, sach. albae, pulv. acacise, aq. distil. 
The only wonder is, of what use he would find the rest of 
the contents of an ordinary drug store, and why he should 
confine this prescription to gonorrhoea. 

Dr. Charles H. Crane has been appointed Surgeon-Gen- 
eral, U. S. A., in place of Dr. Barnes, who has been placed 
on the retired list. A large number of phj^sicians would 
have been pleased to have seen Dr. J. H. Baxter appointed 
to this position, but as it is stated that Dr. Crane was next 
in rank to Dr. Barnes for promotion, and is a reputable 
and capable gentleman, it was his right that he should 
receive the promotion. 



184 The Peoria Medical Monthly. 

We have received the first number of the Medical 
Chronicle, edited by Geo. H. Rohe, M. D., and published at 
Baltimore, Md., at |1 a year. This number contains twenty- 
four pages of good medical reading. We are pleased with 
the frankness of the editor, who says in a prospectus: " This 
journal is published in the joint interest of the medical pro- 
fession and the editor." We hope it will be mutually 
profitable. 

Dr. E. W. Jenks, late Professor of Gynecology in the 
Chicago Medical College, has opened a private hospital for 
the treatment of diseases of women at Geneva, 111. The 
Michigan Medical News says in this connection : '' His well- 
earned reputation as a gynecologist, and his extensive 
acquaintance, are sufficient to guarantee the success of his 
new enterprise from the very beginning," to which we add 
a cordial endorsement. 

Dr. Cathell, author of the valuable work, '" The Physi- 
cian Himself," noticed in our July number, informs us that 
a new edition, thoroughly revised, is in preparation. An 
index will be added, and the matter divided into chapters 
and sections, which will add much to its usefulness We 
advise every reader, old or young, wise or otherwise, to 
obtain a copy and read it carefully. It will be found not 
only interesting, but very profitable reading. 

We take pleasure in especially calling the attention of 
our readers to the article on the "Double Staining of Blood 
Corpuscles," reprinted from the August number of The 
Microscope. Our only regret is that we are not able to re- 
produce the colored lithograph showing the success attained. 
Those who do any work with the microscope should sub- 
scribe for this valuable bi-monthly, as it is the most prac- 
tical journal we know of on this subject. 

The demand for the charts has been so great that we 
have had difficulty in filling orders. We are again obliged 
to ask our friends to have a little patience, as the supply 
ordered is not yet received. We wish again to call atten- 
tion to the fact that these charts are only offered to New 
Subscribers, also that the bound volumes of Vol. I are 



J 



Editorial Department. 185 

ready and will be sent postpaid for $1.50; or to New Sub- 
scribers to Vol. Ill for $1.00 in addition to the regular sub- 
scription price. 

"At a late meeting of the London Obstetrical Society 
(June 7th) Mr. Hopkins Walters exhibited an uterus with 
one ovary and Fallopian tube and a piece of omentum that 
had been torn away by a midwife in the attempt to remove 
an adherent placenta. The patient made an excellent 
recovery." Truly a "tough placenta and a tough w^oman," 
as the North Carolina Medical Journal heads the above 
statement — and it might be added, a tough story. 

The "Boss" Medical College. "The Medical Gazette 
publishes the following letter verbatim et literatim, which it 
received from the Dean of a Western medical college. Is 
it any wonder medical education is in the condition in 
which the times find it? " — Mich. Med. Neivs. 

College of Physicians and Surgeons, 
JoPLiN, Mo., 5, 28, 1882. 

Gents: Please send jjrice list of Doctors and Druggist 
Names by states, as I w^ant to mail several thousand Annual 
Catalogues to the Profession all over the U. S A and canady. 
I am starting an em]3ryotic Pioneer Medical College and I 
must of necessity noise it around the world to make it pay 
me. An early reply will greatly oblige 

yours Respectfully etc 

J. C. Petit M D 
Dean 

Some of our readers may not have seen a copy of this- 
announcement, so w^e will describe some of its features. 
The title page has a cut of the college building, adjoining 
which is " Petit's Hospital Home." The next page has an 
illustration of the dissecting room. Two persons are at 
work; one has a bandage around his head, the other has 
apparently had the side of his head caved in. We suppose 
this is regulation Missouri style. In the center a well- 
dressed person, with plug hat in hand and hair parted in 
the middle, is evidently posing for his picture. This may 
be the Dean, or it may not, but we believe it is. Among 
the Professors are one of Cerebal Physiology and one of 
Ochthalmology. We invite the attention of some other 
colleges to these new^ departments, whereby they mag add 



186 The Peoria Medical Monthly. 

a few more chairs to their faculties. "Women are admitted 
on the same terms as men. A separate lecture room for 
women has been so arranged that the lecturer can be seen 
and heard, but without there being any embarrassment 
to either sex." To the professors, we suppose is meant. The 
fees, including matriculation and demonstrator's tickets, 
are $40, which happen, by a wonderful coincidence, to be 
just the same as those of another college wiiich might be 
mentioned. But space forbids further notice, and we wall 
only say that this is one of the colleges whose diplomas are 
not received by the Illinois State Board of Health. 



New Doctors . 

Certificates of practice entitling the holders to practice 
medicine and surgery in Illinois, were issued to the follow- 
ing named practitioners, during the month of July, by the 
State Board of Health: 

William Dillon, M. D., Thawville, Iroquois county ; diploma, Ohio 
Medical College. 

Almeda Westfall, ]M. D., Chicago; diploma, Hahnemann Medical 
College, Chicago. 

H. M. Vaught, M. D., Bird's Station, Lawrence county; diploma, 
University of Louisville. 

Waldo H. Stone, M. D., Hamburg, Calhoun county; diploma, Bos- 
ton LTniversity School of Medicine. 

Henry H. Rogers, M. D., Fairbury, Livingston county; diploma, 
Kentucky School of Medicine. 

Johan Patzer, M. D., Chicago ; diploma, University of Wurzburg. 

J. W. Propeck, M. D., Mendota, LaSalle county ; diploma, Ameri- 
can Medical College, St. Louis, Mo. 

Stillwell G. Merrill, M. D., Belleville, St. Clair county; diploma, 
Missouri HomQ?opathic Medical College. 

J. B. Marchand, M. D., Monticello, Lewis county. Mo.; diploma, 
College of Physicians and Surgeons, Keokuk, la. 

Smith D. Lou, ^L D., Albion, Edwards county ; diploma. Eclectic 
Medical Institute, Cincinnati, O. 

Fred Humbert, M. D., Alton, jMadison county; dij^loma. University 
of Vienna, Austria. 

Fred Holcomb, M. D., Kensington, Cook county ; diploma, Albany 
Medical College, New York. 

Abraham Lincoln Fox, M. D., Oakwood, Vermilion county ; diploma. 
Rush Medical College. 

George William Field, M. D., Thomson, Carroll county ; diploma, 
Chicago Medical College. 

O. C. Darling, M. D., London Mills, Fulton county ; diploma, 
Eclectic Medical Institute, Cincinnati, 0. 

J. F. Cooper, M. D., Elmwood, Peoria county ; diploma, College of 
Physicians and Surgeons, Baltimore, Md. 



Editorial Department. 187 

Wm. B. Cook, M. D., Verona, Grundy county ; diploma, Bennett 
Medical College, Chicago. 

Frank M. Blodgett, M. D., Chicago ; diploma, Howard University, 
Medical Department. 

Francis G. Bonyoge, M. D., Chicago ; diploma, Royal College of 
Surgeons and King and Queen's College of Physicians, Ireland. 

John F. Bigelow, M. D., Chicago ; diploma. Rush Medical College, 
Chicago. 

W. T. Knapj), M. D., Casey, Clark county ; diploma. Starling Medi- 
cal College, Columbus, O. 

George H. Randell, M, D., Chicago ; diploma. University of Michi- 
gan. 

A. G. Blanchard, M. D., Seneca, LaSalle county ; diploma, Eclectic 
Medical Institute, Cincinnati, O. 

Kate D. Munn, M. D;, Chicago ; diploma, Bennett Medical College, 
Chicago. 

Thomas Addison, M. D., Chicago ; diploma, Bellevue Hospital Medi- 
cal C'ollege, New York. 

A. W. Avery, M. D., Beardstown, Cass county ; diploma. Long 
Island College Hospital, Brooklyn, N. Y. 

J. B. Shoemaker, M. D., janesville, Coles county ; diploma, Ken- 
tucky School of Medicine, Louisville, Ky. 

Belle Seward, M. D., Rockford, Winnebago county ; diploma, 
Hahnemann Medical College, Chicago. 

John H. Faucett, M. D., Grant Park, Kankakee county ; diploma, 
Missouri Medical College, St. Louis. 

Philip Moeser, M. D., New Athens, St. Clair county ; diploma, 
American Medical College, St. Louis. 

Frances A. Prindle, M. D., Streator, LaSalle county ; diploma, 
Woman's Hospital Medical College, Chicago. 

John F. Snyder, M. D., King's, Ogle county ; diploma. Rush Medi- 
cal College. 

Oman G. Gowin, M. D., Morrisonville, Christian county ; diploma, 
Eclectic Medical Institute, Cincinnati. 

George H. Hunt, M. D., Paris, Edgar county ; diploma, Pulte 
Medical College, Cincinnati. 

Ella M. Patton, M. D., Rockford, Winnebago county; diploma, 
Michigan State University. 

Granville W. Prewett, M. D., Livingstone, Clark county ; diploma, 
Missouri' Medical College, St. Louis. 

Hamlin J. Waters, M. D., Albion, Edwards county ; diploma, 
Miami Medical College, Cincinnati. 

D. W. Smith, M. D., Bement, Piatt county; diploma, Jefferson 
School of Medicine, Louisville, Ky. 

Perry Waltman, M. D., Dudley, Edgar couney; diploma. Eclectic 
Medical Institute, Cincinnati, O. 



Receipts. 

To save the time and expense requisite for sending 
a formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the name of 
those from whom money has been received during the pre- 



18S The Peoria Medical Monthly. 

ceding- month. Those remitting will please note whether 
their names are included in the lists, and if they are not, 
will notify us by card : 

IixiNOis — Drs. J. B. RaiuUeson, A. F. Burnham, T. W. Keys, Mrs. S. A. 
Coulter, S. A. Hopkins, Weis & Tice, O. J. Roskoten, Geo. X. Jennings, B. Curti, 
M. J. Jones, C. C. Allen. 

Iowa — Dis. Maxwell & Bowman, Perry Engle, J. X. NoitIs, J. B. Gardner.. 
E. J. Shelton. 

WiscoxsEN — Drs. H. D. Hill. H. Hunt, W. Hanna, W. Monroe. 

Xebraska — Dr. M. Enrigbt. 

Arizona — Dr. O. B. Adams. 

MissorRi — Drs. W. F. Boyer, S. F. Bonney, L. S. Brown & Son. 

Ohio— Drs. H. B. Martin, E. B. Hiestand, J. T. Mason. 

Florida — Dr. L. R. Quackenbush. 

Iv.\jfSAS — Dr. A. G. Brown. 

Minnesota — Drs. H. Schumann, T. Kirk. 



Transactions of the American Medical Association. 

The Publication Committee have been Avorking very 
rapidly during the past few^ weeks, and will have all the 
manuscripts in the printer's hands by the 5th of August. 
At their first meeting they passed resolutions requiring all 
contributions referred to them to be in the hands of the 
Secretary by the 31st of Julj", to insure insertion in the- 
annual volume. All corrections made by authors on the 
proof sheet, differing from the original manuscript, will 
only be made at the expense of the author. 



To Hasten the Action of Quinine. 

Dr. Starke (Berliner Klin. Wochenschrift) advises that, 
before swallowing powder or pills of quinine, a weak tar- 
taric acid lemonade be taken. This procedure not only 
greatly accelerates the solution and absorption of the 
quinine, rendering its physiological action much more 
prompt, but also obviates the unpleasant gastric irrita- 
bility so common after the administration of large doses 
of this drug. 



The Peoria 
MEDICAL MONTHLY. 



Vol. III.- — SEPTEMBER, LSS2. No. 5. 



(!)riginal CTommutticatiott^. 



Akt. I— Case of Acute Diabetes 3Iellitus with Albuminuria. Death from 
Uraemia. By Robert Roskoten, M. D., Peoria, 111. 

Quite early in the morning on the 22d of last May, I 
was summoned to Mrs. W., a rather corpulent widow, 43 
3^ears of age. Patient stated that the day before she had 
taken some cathartic pills without effect, and was com- 
plaining of the most intense pains shooting from the middle 
of her l;>ack forwards and downwards to the abdomen. I 
found her suffering from constant nausea and repeated 
vomiting, which greatly increased the pain. Her extremi- 
ties were cold, covered with perspiration; great dyspnoea; 
pulse very small, 120. Her abdomen was slightly tympan- 
itic, ])ut not tender: tongue coated with a thin, whitish fur. 
The patient being in great agon 3^ and constantly clamoring 
for relief, I refrained from making a more thorough exam- 
ination, noticing only the absence of strangulated hernia. 
Administered aromatic spirit of ammonia: ordered brandy 
punch, the application of a mustard plaster and an enema.. 
Morphia was prescribed in combination with subnitrate of 
bismuth, the patient objecting to the hypodermic injection. 
In the afternoon found jDatient but little improved; though 
emesis had subsided, constant nausea was still present. 
Used injections with spirit of turpentine, which caused a 



190 The Peoria Medical Monthly. 

large, natural defecation. No passage of urine since 
previous night. Used catheter and obtained about one 
ounce of a dark brown urine, which was reserved for 
analysis. Dyspncea still great; examined chest. Sounds of 
heart very weak, otherwise normal. No signs of oedema 
or other pathological condition of the lungs. 

At 9 o'clock p. m. all pain had ceased, excepting in the 
renal region, which was so tender that patient objected to 
any change of her position. There was a good perspira- 
tion: found temperature normal; pulse 90; difficulty of 
breathing, however, continued, nor had she micturated. 
During my presence vomiting of bilious matter occurred. 
Prescri1)ed calomel and opium, one grain of each every 
three hours, and a mixture of ammonii acetas and spiritus 
nitri dulcis. 

I was unable to test the urine until late in the evening. 
Reaction acid; heavy sediment of urates: blood-casts. After 
filtering the urine a large quantity of albumen was pre- 
cipitated by nitric acid. 

May 23, patient better: slept for several hours; emesis 
and dyspncea gone. Skin moist, temperature 98; sponta- 
neous normal operation. Five ounces of urine during the 
last twenty hours; specific gravity 1.032; quantity of albu- 
men same as the day before, but this time applying the 
test for sugar found it present in large quantity. A few 
slight chills seemed to point towards malarious influences 
and induced me to use quinine. Continued diaphoretics. 
Patient did well during the day until about 10 o'clock p. m., 
when suddenly a change took place. The upper extremi- 
ties (the lower in a less degree) became cold, pulse of ra- 
dial artery scarcely perceptible; dyspnoea intense and pupils 
enlarged, though patient remained conscious. Kept the 
peripheric circulation up by rubbing the limbs with irrita- 
ting substances and the application of hot cloths around 
them. Injection of brandy with quinine; liberal use of 
stimulants internally. Gradually the pulse came up again, 
but the upper extremities remained cold for fully thirty-six 
hours; their temperature was even lower than that of the 
surrounding medium, probably caused by the profuse per- 
-^piration. 



Original Communications. 191 

May 24, pulse still very weak — 100. Dyspnoea abated. 
About 10 ounces of urine during the last twenty-four 
hours. Specific gravity 1,030. Albumen and sugar di- 
minished. Apprehending the occurrence of a similar at- 
tack, 1 used quinine in large doses. Nothing remarkable 
occurred during the next few days; the pulse became nor- 
mal in every respect. Under the use of potassii acetas the 
quantity of the urine became larger, its color lighter, albu- 
men and sugar considerably less. A slight indigestion was 
overcome by elixir of pepsine with bismuth, a troublesome 
flatulence by the use of recently burnt and pulverized char- 
coal. The renal region being still painful and tender on 
slight pressure, I suspected a consecutive perinephritis. 
The pulse by this time having regained some vigor, half a 
dozen leeches were applied over the seat of the pain, by 
which suffering was relieved. 

Practical reasons precluded the use of an otherwise in- 
dicated warm bath at any period of the disease. 

May 25, a severe haematuria set in. Used ergot with- 
out effect, but succeeded in arresting it with plumbi acetas 
and opium. After the haematuria had subsided, patient did 
admirably well. The functions of all organs seemed to 
have returned to their physiological state. The only patho- 
logical condition was the presence of traces of sugar and 
albumen in the urine: even the pain in the renal region had 
almost entirely disappeared. During the most trying 
period of her disease, patient, contrary to my wishes, de- 
clined counsel, but on May 28 requested it immediately at 
my entrance. Dr. R. Boal, to whom I applied, kindly 
answered to my call. The most scrutinous examination by 
this vastly experienced ph5\sician also failed to discover any 
immediate danger. Beyond a great nervousness no symp- 
toms of an alarming nature were present. 

Afterwards I learned from the attendants of patient 
that she asked them not to allow her to fall asleep, since 
she feared never to awake again. This fear may have been 
caused by an iudistinct premonitory sensation of the im- 
pending coma. In order to overcome the nervous excite- 
ment we used Hoffmann's anodyne with paregoric and 
Talerian, with good effect. Until the evening of May 31 



192 The Peoria Medical Monthly. 

everything went on fairly, when suddenly dyspnoea super- 
vened. The pulse became small and fluttering (130), diu- 
resis imperfect, only three ounces of urine during the 
whole day. After Altering it. its specitic gravity showed 
l,0o7. abounding in sugar and considerable albumen. 

During the whole disease no oedema of the extremities 
could be noticed. l)ut now, for the fii-st time, her eyelids 
became (edematous. 

On the morning of June 1 crepitation could be heard 
over both lungs; pulse very small, respiration labored. 
Urine scant, of the same quality as the day before. Sub- 
sultus tendinum and coma. Patient died in the afternoon, 
on the eleventh day of her sickness. Post mortem not 
permitted. 

On account of pressing demands on my time I was 
unaltle to take as perfect notes of the case as were desir- 
able, but I hope that they may be sufficient to impress upon 
the reader the gravit)- of the prognosis whenever diabetes 
and albuminuria occur simultaneously in a patient. 

My theory of this case is that the diabetes was pre- 
existing, and that by exposure to cold a diffuse nephritis 
was contracted. This exposure occurred the day before I 
was first called, during the disinterment and removal to a 
distant cemetery of the bodies of her husband and nephew, 
who were killed by an accident ahout a year ago, the 
weather being wold and rainy. The shock upon the nerv- 
ous centers of the patient, produced hj the scenes wit- 
nessed on that occasion, may have aggravated the diabetes. 



*Akt. II. — On the Resources for Meeting Emergencies: witli Cases in Prae- 
tiee. By Henky S. Bell. M. D., Paris, 111. 

We doubt if there is any pursuit followed by man 
where emergencies so frequently arise as in the practice of 
medicine and surgery. Therefore when you add this to 
the almost constant anxiety experienced by physicians for 
the welfare of their patients, you at once have a fair con- 
ception of the responsibilities assumed by the doctor. 

* Read before Ihe .Esculapian Society of the Wabash Valley, at its Semi-an 
nual fleeting in Champaign, 111., May 31, 1882. 



Original Communications, 193 

« 

We, who have so painfully realized these momentus 
facts, need not necessarily be told that these things are 
true. But we can be profited by discussion, and thus be 
better prepared to meet the difficult conditions when they 
do arise. They have often, and will again often face each 
and all of us. We but delude ourselves if we shut our 
eyes to the probability of escaping these trying problems; 
and the man who does not take the pains, the labor I 
mean, to master these extraordinary events, usually shuts 
his eyes when brought face to face with cases, the gravity 
and unusual character of which must test his knowledge 
and skill. The consequence of this groping practice is 
often enough disastrous to the patient and family, and if 
the doctor has the confidence of those in the immediate 
neighborhood, he comes out with neither blame nor credit, 
but nevertheless feeling very much self-reproached for his 
weakness. 

We may classify doctors under three heads regarding 
the matter of emergencies: 1st. Those who either do not 
know, or knowing, have not the pluck to act. but move 
about in a fussy way to make believe that thej^ are doing- 
something, though in reality the}^ are doing nothing, while 
the patient's life is slowly or rapidly, as the case maj^ be, 
passing away. The second class comprise those who are 
ignorant in evevy sense, that is they know none of the 
principles of medicine and surgery, neither have they the 
common sense of the first class to abstain from action, 
which is far more commendable, but work furiously away 
without reason or purpose until exhaustion of the doctor, 
or the death of the patient, puts a stop to tiuch misplaced 
pluck. The third class, I am happj^ to believe, comprise 
the larger number of physicians; and country practitioners 
make up a relatively larger number of this class of careful 
but active men. The reason for this is owing no doubt to 
the fact that experienced counsel is not always at hand 
when these emergencies occur. Therefore the doctor out 
in the prairie or down in the woods is thrown entirely back 
upon his own resources. These circumstances are. often so 
trying as to make the man for the time forget his humble 
position in the profession, and he is thus stimulated by the 



194 The Peoria Medical Monthly. 

emergency to do onlj^ what he heretofore considered possi- 
ble for eminently experienced men to do, and thus in his 
hour of self-dependence saves a human life perchance, and 
discharges a duty that he had not deemed himself capable 
of undertaking. And each difficulty encountered and suc- 
cessfully met gives him increased courage and confidence; 
and thus case by case, he grows in real usefulness, and in 
this way acquires an ability that no college course can give 
or text book impart. 

If this bedside experience is so valuable and indispen- 
sable to the successful physiciain, the mutual discussion of 
our varied experiences is certainly the next thing to the 
practical realization of these important questions. Hence 
the object of this paper. Much or all that is said here may 
seem simple and comparatively insignificant. The reason 
for this is it requires much less mental labor and subtle 
responsibility to tell of an action than it does to engage in 
one. However, we have all had many repetitions of such- 
cases, and cases very like those to which I shall presently 
allude. And in this relation it may be properly asked: 
Are we always ready to grasp these unexpected emergen- 
cies with an iron grip, and thus, as it wei'e, thrust them 
down? Are we equal to our opportunities? Do we strive 
to attain that high degree of usefulness which is within 
our power ? 

I believe that many or most of us reflect the ordinary 
skill of our profession, and that too. without a strained 
effort. Now if we are ordinarily competent as it is, how 
much better we may become by habits of industry and 
perseverence; by following carefully the progress of our 
science and art as we find it recorded in journals and new 
books; by studying our own cases and writing our conclu- 
sions, or reporting instructive cases to our societies or local 
journals. These simple though perhaps laborious exercises 
are the ways and means of making ourselves better 
doctors. 

It may be said by the busy practitioner that the time 
and labor expended in the daily routine of making calls 
and prescribing for his patients leaves no time for careful 
reading or undisturbed thought. This is a reasonable 



Original Communications. 195 

statement, and one that is quite sufficient to palliate the 
ambition of many. But we must, at the risk of sacrificing 
the few hours for social pleasure which we enjoy, delve 
deeply in the mines of medical discussion, that we may 
ourselves become enlarged and thus endeavor to keep j)ace 
with our profession. 

Let us seek to emulate the beautiful sentiment 
expressed by a celebrated opera singer when she said, when 
she began life in a lady's kitchen she resolved to wash 
dishes better than anybody, and now that she had risen 
from that humble station, she was still determined to sing 
better than other members of the company. 

The cases to which your attention shall now be called 
will no doubt impress us with the importance of having 
an abiding knowledge that will serve us well in the hour 
of greatest need. 

About 9 o'clock on the night of March 19th, 1882, 1 was 
called several miles into the country to see Mrs. H. H., age 
22 years, who was said to be in labor with her first child. 
Soon after arriving I made a digital examination and very 
quickly determined that it was a breech presentation with 
coccyx of child to left acetabulum of mother. The os was 
well dilated, and everything in normal condition except the 
character of the pains, which were frequent and non- 
expulsive. This, however, did not particularly excite my 
apprehension, as she seemed young and strong. I there- 
fore informed the husband and neighbor women, in whose 
care the patient had been since the commencement of her 
labor, twenty-four hours before my arrival, that the case 
was a breech presentation, and that while it would be 
somewhat more tedious than ordinary labors, nevertheless 
she would get through all right and was making fair pro- 
gress. This assurance which I gave the lady and her 
anxious friends w^as based on the excellent condition of the 
OS, it being enormously dilated, soft and lubricated, and 
the fact that we are taught by obstetrical text-books and 
professors that breech labors are natural and do not, as a 
rule, require any interference from the accoucher. The^ 
buttocks of the child were excessively large, or at least ap- 
peared so to the feel of the index finger, and they had not 



196 The Peoria Medical Monthly. 

jet become engaged in the pelvic brim. I took a seat by 
the bedside of my patient, and she labored hard from hour 
to hour: and as the clock regularly tolled out the passing 
hours of the night. I would as frequently make the usual 
examination, and each succeeding time I would find that 
there was no further progress. And as the w^ee small 
hours of the far-advancing night came on, the patient and 
friends w^ould look to me for some signs of the fulfillment 
of my early prophesy. This and the unerring indications 
of the prostration of the patient made me tW'ist about 
nervously in my seat. As things went on in this way, I 
would occasionally go to the door to see if the storm, which 
had been raging without all night, was showing any signs 
of letting up. I decided about 8 o'clock in the morning, 
that the patient would not get through soon, if at all. un- 
aided; and I thought it would be a great relief to me to 
have professional assistance and a case of obstetrical in- 
struments. But there I w^as. several miles from town, the 
night black with darkness, the rain pouring down in tor- 
rents and the prairie roads almost impassable. Added to 
the fury without, there was within the despairing moan of 
the poor patient, the beseeching expression of the faces of 
the old women, and the exhausted energies and demoral- 
ized spirits of the writer. Thus bewildered, I almost un- 
consciously strolled into an adjoining bedroom, and dropped 
down upon the couch to meditate upon the serious ex- 
ti-emity in which I found myself. While thus trying to 
think, the kind hearted old grandmother w^ho was in at- 
tendance w^hen I arrived, came into my room and recited a 
case just like this, which she had seen in Ohio in her younger 
days, which, she said, despite the best efforts of the best 
doctor in the neighborhood, died undelivered. This ex- 
perience of the old lady fired up in}' tired energy, and I at 
once resolved that my patient should not die in parturition, 
I informed the husband that in the interest of his wife's 
life it w^ould be necessarj^ to deliver her without delay: that 
the safety of the child was alread}^ jeopardized and that 
breech presentations were especially disastrous to children^ 
and that in all probability the child would be still-born. 
Having the consent of both husband and wife. I at once 



Original Communications. 197 

administered chloroform, made a careful examination and 
found the buttocks high up, but still inclined to engage at 
brim. The child appeared so large I thought it would be 
a very difficult task to bring the feet down: and, besides, I 
thought it would prejudice the welfare of the mother more 
to pass my hand entirely in the uterus and turn, than to 
carry out the plan I had matured. I asked for some strong 
iron wire, which was brought, and with a pair of pliers I 
readily converted it into a blunt hook and also turned the 
opposite end of the wire into a smaller hook, in order that 
it could not slip from my grasp. T carefully wrapped the 
instrument with candle-wick, and then proceeded to pass 
it in the vagina and over the left groin of the child, which 
was easily done. I had previously tried to pass the tape or 
fillet, as it is technically called, over the groin with my 
fingers, but failed after two or three trials. Now with my 
right hand I made traction upon the blunt hook, with the 
index finger of my left hand covering the point or end of 
the hook, and thus guarding the soft parts of the mother. 
The traction necessary to bring the child down was very 
great, and was made synchronously with the Literine con- 
tractions. In a little while and while using considerable 
force, I distinctly heard a sudden snap which too plainly 
indicated that I had broken the child's thigh. This must 
have disconcerted me very much, but I thought that I could 
not abandon the case then, and continued the traction un- 
til the buttocks were brought down sufficiently low, when 
I removed the improvised hook, and then passed my fingers 
over the child's groin and delivered it in a few moments. 
To my great surprise and chagrin the child was alive and 
cried out lustily. I thought to myself, if there ever was a 
time when a still birth was a comfort, this was the one. 
However, I quickly handed it to the nurse and turned to 
the exhausted mother only to find that she was having a 
most frightful post-partum hemorrhage. I at once grasped 
the fundus uteri through the abdominal walls, but could 
not excite it to contraction. I forthwith passed my right 
hand into the vagina, with all the fingers in the uterine 
cavity, still continuing the external pressure with my left 
hand. The blood continued to pour out in torrents and the 



198 The Peoria Medical Monthly. 

womb refused to contract. I then called for some cider 
vinegar, saturated my handkerchief with this and carried 
it into the uterine cavity, and instantly the womb con- 
tracted, forcing my fingers out in the vagina. However I 
left the handkerchief in the cavity fully an hour, almost 
fearing to remove it. Xo recurrence of flooding followed 
its removal. 

By this time, when I knew the immediate danger of 
the mother was passed. I became perfectly worn out with 
physical labor, mental strain, and terrible responsibility. 
After an hour's rest upon a couch, breakfast was announced. 
But my appetite was gone, and the task of choking down 
a biscuit aiid answering the ominous inquiries of the 
women present, was the most disagreeable of my life. 
However the embarrassment must be met, and I frankly 
confessed to my company that the child had sustained a 
fracture of the left thigh bone, and that it were better that 
the mother be not informed until she had slept some and 
rallied somewhat from the shock of her labor. When the 
ladies had breakfasted T set about to do up the ])roken limb 
with a pasteboard dressing. The child would flex her 
thighs upon her abdomen, as all new-born babies will, and 
this circumstance very materially interfered with putting 
up the limb: so 1 decided to relax the young one with 
chloroform, which I administered myself, and when the 
babe was anaesthetized, I gave the handkerchief to the 
lady upon whose lap the child was lying, and carefully 
directed her how and when to use it, and at once busied 
myself with the dressing. Unfortunately the lady to whom 
I entrusted the chloroform was as intent upon seeing the 
fracture dressed as I was absorbed in the work in hand. 
Presently some one standing by cried out that the child 
was dead; a glance sufliced to prove this too true. The 
child was black in the face, limbs and body completely 
cyanosed, and respiration gone. I put my ear to the child's 
breast and thought 1 detected a faint fluttering of the 
heart. I lost no time in resorting to artificial respiration; 
inverting the child's body and douching it with cold water. 
While engaged in this apparently cruel proceeding, I was 
beseeched by the ladies present to desist for pity's sake. 



Original Communications. 199 

that the child was dead, and that the poor thing had been 
tormented quite enough for one so young and tender. Of 
■course these appeals were annoying to me, but I had 
resolved that the child should live, and finally returning 
life was manifested by occasional gasps from the child, and 
as artificial respiration was vigorf)usly practiced, the inter- 
vals between the gasping breathing became less and less, 
.and soon the child's color and breathing became normal 
and the dressing was finished. The child hovered between 
life and death for two days with spasms. I gave it one 
grain of bromide of potash every two hours, not believing 
that it could recover. However at the end of two days it 
seemed all right, and I removed the pasteboard, and substi- 
tuted a plaster of paris dressing, first enclosing the limb in 
cotton batting and securing this with a roller bandage. I 
was careful to inclose the upper part of the thigh and but- 
tock with oil silk, to prevent urine and fseces from satu- 
rating the cotton. 1 applied the plaster of paris with the 
limb strongly extended, but at this dressing 1 dispensed 
with the use of chloroform. The plaster bandages were 
carried around the hips, back and abdomen of the child in 
form of spica, and in this way secured fixation of dressing 
and complete immobility of fragments. 

The further progress of child and mother was all that 
could be desired, the mother leaving her bed quite strong 
by the tenth day; and by stuffing bits of absorbent cotton 
between the dressing and groin, the discharges from child 
did not complicate matters. At the end of four weeks re- 
moved dressing, found union perfect, without shortening 
and no abrasion of cutaneous surfaces. 

Case 2d. March 3, 1882, Mrs. Judge T., aged 30 years, 
mother of two children, youngest nine months old, con- 
sulted me regarding her health. She complained of ach- 
ing over entire body and dated this ill-feeling three months 
back. She came unwell when baby was six weeks old (the 
child nursing the bottle altogether) and had been quite 
regular since, until in last January, when she was unwell 
three weeks, with but few days of this time free from flow. 
Came unwell February 20, continued three days, then 
ceased for five days, when on February 28 came so again 



200 The Peoria Medical Monthly. 

and has continued so to date ( March 8 ). Pulse 100, lying 
down; temperature normal, bowels constipated. I advised 
rest in bed and prescribed for her bowels a pill containing: 

I^ Podophyllin, t-10 irrains. 

Ext. Beiladona, 1-10 grains. 
Ext. Nux Vomica, ^4 grain. 

Ext. Hvosc-yauii, ^4 grain. 

Pul. Capsicum, U grain. M. 

S. One pill every three hours until bowels acted, then 
one pill night and morning for a while. She w^as also to 
take a teaspoonful of fluid extract of black haw every 
three or four hours. 

I saw her at intervals of once a week for the next 
month. She did not do any good, and on April 2d, while 
over the vessel, a fcetus of about three months' develop- 
ment passed from her into the vessel without the slightest 
pain. The afterljirth not following, she made strong trac- 
tion on the cord and tore it from its attachment to the 
placenta. After several hours I was summoned and shown 
the fcetus and the napkins she had used, but could find no 
placenta among the clots. I passed my finger readily into 
the womb, but could not distinguish the afterbirth. I so 
informed her, and expressed the opinion that the placenta 
had certainly come away. She, however, was certain it 
had not. I administered an injection of hot carbolized 
water in the uterine cavity and directed vaginal injections 
twice each day. and gave her full doses of fluid extract of 
ergot and large doses of quinine, and continued thus for 
several days. The flooding continued and at end of ten 
days from time of abortion the flooding was so great that 
something more than mere temporizing had to be done. 
I dilated the cervix with slippery elm root and passed in my 
finger, broke down the placental mass and removed as 
much as I could with finger and dressing forceps. The 
placental mass now hung from the fundus, size and shaj^e 
much as one's thumb. It seemed soft and friable and easily 
crumbled under my finger and dressing forceps. I removed 
as much as I could, the patient meantime enduring con- 
siderable pain from the manipulation. I again threw into 
the womb several pints of hot carbolized water. She had 
no more flooding, made a rapid recovery and has since re- 
mained well. 



Original Communications. 201 

Akt. III. — Treatment of Dysentery. By I. .J. M. Goss, Marietta, Ga. 

Acute dysentery is prevailing in all the southern por- 
tion of United States, and is proving fatal wherever it is 
not properly treated. As 1 have treated it extensively for 
near forty years. I will add my experience for the benefit 
of suffering humanity. 

In most cases where the subject of dysentery is young 
and vigorous, aconite, in doses of i to 1 drop, every half 
hour, with 10 to 15 grots of gelseminum, given until a de- 
cided impression is made upon the circulation, which is 
usually in two hours; then the same quantity maybe given 
at longer intervals, say every two hours, to keep down 
inflammatory excitement. At the same time I have found 
aid from the use of some saline cathartic, and I have found 
the sulphate of soda the best, which should be given in 
doses of 1 drachm every three hours, until it produces a 
cathai-tic effect, then in doses of two grains to keep up a 
loose state of the l30wels. I seldom give opium, unless it 
is in cases where the aconite and gelsemium fail to relieve 
the tenesmus and tormina: then I give about 25 drops of 
McMumis' Elixir of Opium every four hours, until the ner- 
vous system is quieted and the pain relieved. In some 
cases that have been neglected, and where the tormina and 
tenesmus are persistent, and the patient's passages are 
very slimy and bloody, and sometimes clots of blood like 
lumps of flesh, then small doses of bichloride of mercury, 
say the one one hundrdth of a grain every two hours, until 
the passages are changed to a more natural character. T 
have seen this type of dysentery improve rapidly under 
this remed}". I have had several cases recently among 
children that I relieved with this remedj' in a few days. In 
many cases of dysentery that I have had this season, espec- 
ially among children, there was great nausea and vomiting. 
In these cases I use smalldoses of tincture of ipicacuanha, 
say 1 to 2 drops every three hours. 



Dr. Desnos (Journal de Medecine de Bordeaux) claims that 
the carbolic spi-ay, applied directly through the canula after 
tracheotomy, has a marked effect in j)roducing expulsion of 
the false membranes. 



202 The Peoria Medical Monthly. 



Race Adulteration. 

August, 1882. 
Editor Peoria Medical Monthhj: 

** Thou shalt not commit adultery," was the law pro- 
pounded four thousand years ago, and the wholesomeness. 
I believe, of the commandment has never been questioned. 
Jewish jurisprudence defined adultery only in one sense 
and that has stood only as a regulator of society, and with 
what success is a question to be reflected upon. 

In this paper I wish to inquire what adultery iii per se, 
not particularly what it is thought to be. In this enlight- 
ened age what is best to do to remedy an evil which in the 
aggregate is alarmingly patent to any observer ? What is 
adultery ? Why, to hold sexual intercourse with another 
man's wife or another woman's husband. Yes, according 
to general law and thought. 

If I were talking about sugar, tea, flour, whiskj^, or any 
of those things belonging to meats or drinks, you would 
say any other substance added to the article that would 
render it impure, inert, worthless or dangerous, would be 
to adulterate it. Our medicines are adulterated until we 
hardly know where to go for a genuine article. When we 
prescribe for our patient we hardly know if we shall cure 
or kill, simply because of adultery. How many lives are 
destroyed annually because of adultery ? and yet the crime 
is passed by as of little moment. If the adulterer should 
add to the article something more valuable, a better article 
of the same kind even, he would soon obtain thanks, and 
the cry of adultery would soon be changed to the laudable 
one of a wholesome mixture. All this in business; but 
when we come to the social side of life adultery puts on 
another phase. In the generative sphere of life adultery 
is looked at through another medium. How well and con- 
sistently let us for a short time examine. When I was 
quite a young man in my profession I lived near two fam- 
ilies. One family consisted of husband and wife, both 
blonds, who were brought up together, being second 
cousins. They thought it no wrong to intermarry as they 



Correspondence. 203 

loved each other. The fruit of the pair when I first knew 
them, was one child, some five years old, in the cradle, an 
idiot; and a babe in the mother's arms, disfigured with a 
cleft palate, heir lip, and with ill-proportioned head and 
expressionless eye. The mother had miscarried once with 
pleasure. ■ 

The other family were brunettes, distantly related. 
Their offspring was no better, a boy, all drawn out of shape 
by rickets, his head several sizes too large, and his mother 
after one abortion had remained sterile. And yet to look 
upon, these four parents were perfect in form, smart, in- 
telligent, active people. Now, what was the trouble ? 
Adultery per se. The common accepted opinion would be 
mismarriage, but adultery would be a better word. The 
seed was spoiled by adulteration. These two families were 
on the most intimate terms and could have intermarried 
differently, but found their mistake too late. They could 
have divorced and remarried, but the obnoxious offspring 
was in the way; at least the idiot in the cradle was too- 
much for Mrs. Brunette. It had been suggested by an old 
physician that they exchange partners all around, which I 
had reasons to think had been temporarily done, as each 
lady gave birth to a perfect living child, Mrs. Blond pre- 
senting a fine boy to her husband, strongly marked with 
the brunette, and vice versa with Mrs. Brunette. After 
some years I lost sight of all the parties, and since then 
my observation has led me to think that adultery was not 
pe?- se what the legal statute makes it, but that the com- 
mand should and must bear heavier on the crime of bad 
procreafiiif/. 

" Thou shalt not commit adultery " was from God, but 
the defining of the law was from man and man has ever 
had to suffer the penalty of bad construction. 

Knowing, as the medical man does or should know, the 
terrible consequences of human adulteration through the 
laws of marriage and the ignorance of the masses, a ter- 
rible responsibility rests on them as a body, in the direction 
of a sanitary reformation in society; but then as individuals 
the profession is hampered by preconceived opinions of 
social and religious cast that it is almost impossible to 



204 The Peoria Medical Monthly. 

surmount. I sometimes think it were better the law de- 
fining and punishing adultery were to become a dead letter 
on OLir statute books, unless it can be modified. Deformed 
idiots, mental depravity and a legion of eyil propensities, 
besides the criminal acts which arise from the forced con- 
tinuance of adulterous intermarriages, are being forced 
upon society by the mistaken idea that men and women 
should continue to liye together when once they have plight- 
ed their troth. I would not eyen suggest the thought that it 
would be right to overstep the law. but I would suggest the 
thought that by so doing a man or woman would approach 
infinitely nearer the right than in continuing to propogate 
fools and deformed children according to law. The curse 
of man might fall heavier, but the curse of God would cer- 
tainly be lighter. What so terribly damning as a deformed 
imbecile, and to feel I am guilty of its being. 

Lux. 



I 



goofe potoisi. 



The Change of Life in Healtli and Disease. A Cheniioal Treatise on the Dis- 
eases of the Gan,2:lionic Nervons System Ineidental to Women at tlie De- 
cline of Life. By Edward John Tilt. ^M. D., Past President of the 
Obstetrical Society of London, etc., etc. Cloth, 8 vo., 184 pp. Price, !|1.2.i: in 
paper 75 cents. P. Blakiston, Son & Co., Philadelphia, 1882. 

Dr. Tilt is well known to many American readers as 
one of the foremost of the British conservative gynecolog- 
ists. His "Hand Book of Uterine Therapeutics"' has gained 
for him many friends and warm admirers in this country 
who will heartily welcome any additional work from his 
pen. In the work before us he has the advantage, over 
most authors, of being the only writer on the above sub- 
ject in our language. The subject, we believe, is not gen- 
erally understood, and any systematic treatise upon it will 
receive prompt recognition as filling a long felt want on 
the part of the profession. The tables with which the 
work abounds are by no means the least interesting part of 
its contents, and will not fail to throw light upon many 
hitherto mooted points in regard to the climacteric changes 
of women. As the l)est, in fact as the only book upon the 



Book Notices. 205 

subject so far as known to us, we heartily recommend it to 
our readers. The paper and binding is excellent, and the 
type and presswork very good. 

What to do in Cases of Poisoning. By William MrRRELL, M. D., M. R. C. P., 

etc. Second Edition, Vest Pocket Size, Cloth, pp. 96. Geo. S. Davis, Pub- 
lisher, Detroit, Mich., 1882. 

This is one of those handy little books which we can- 
not well do without, and which should never be misplaced. 
Besides containing the antidotes for the more common 
poisons, it gives the treatment for those which would 
puzzle almost anyone without its instructions, such as the 
"Vermin Killers," "Rat Pastes'" and some of the most 
poisonous patent medicines. It covers the ground better 
than any book of its size on the subject that we are ac- 
quainted with, and should be in the hands of every practi- 
tioner of medicine. 

Mental Pathology and Therapenticg. By W. Griesixger, M. D., Professor of 
Clinical Medicine and of Mental Science in the University of Berlin, etc. etc. 
Translated by C. L. Robertson, M. D., (Cantab) and James Rutherford, M. D., 
(Edin.) 8 vo., Cloth, pp. 375. W. Wood & Co., Xew York, 1882. 

This is a translation of the second edition which was 
made in 1867, and if anything of a later date can be found 
in the volume we have not been able to discover it. .Of 
course this does not detract from the value of the book as 
then written, for Dr. CIriesinger is well known as one of 
the ablest alienists on the continent, and his work is one 
of the classics of the subject, yet if the reader desires a 
work comprising the more recent investigations and teach- 
ings on mental disease and its treatment, he will not find 
them in this book. "VVe have read this work with much 
interest and profit, and can recommend it to every one in- 
terested in medical psychology. 

Diseases of the Rectum and Anus-. By Charles B. Kelsey, M. D. Surgeon 
to St. Paul's Infirmary for Diseases of the Rectum, etc., etc. 8 vo.. Cloth, 
pp. 300. Wm. Wood & Co., Xew York, 1882. 

Few volumes of Wood's Standard Library for 1882 will 
receive a more cordial welcome from a large number of 
general practitioners than the one before us. Diseases of 
the Rectum and Anus have become a recognized special 



206 The Peoria Medical Monthly. 

branch of surgery, and as such is entitled to a literature of 
its own. The subject is fully treated from an always prac- 
tical standpoint in this vrork and the recent advances care- 
fully gone over. The various chapters are as follows : 
Practical Points in Anatomy and Physiology, Congenital 
Malformations, General Rules Regarding Examination. 
Diagnosis and Operation, Inflamation of the Rectum, Al.is- 
cess and Fistula, Hcemorrhoids, Prolapse, Non-malignant 
Growth, Non-malignant Ulceration, Non-malignant Stric- 
ture, Cancer, Impacted Faeces and Foreign Bodies, Pruritus 
Ani, Si^asm of the Sphincter, Neuralgia, Wounds, Rectal 
Alimentation. The author has done his work well, and 
has given us a very interesting and instructive book. 



Improved Plianiiacy. 

The fact is not new. but it has l;)een quite recently 
made more prominent by Sidney Ringer in his Handbook 
of Therapeutics, that small doses of medicine frecjuently 
repeated act more efficiently than large doses given at 
longer intervals. Bartholow. Petero, Desau, and manj^ 
others, also recommend the use of minimum doses in al- 
most every variet}' of disease. M}' attention was first called 
to this subject b}' my friend and former partner, Dr. J. B. 
Cook, and by observation and actual experience I have so 
convinced myself of their effiacy that, with one or two 
exceptions, I have discarded the larger doses, and by doing 
so have, I am sorry to say, been charged with practicing 
homoeopathy. The believers in medicine and tlieir efficacy 
in treating disease do not appear to increase. On the con- 
trary, it is rather refreshing to meet with a practitioner 
now-a-days with any reliance on drugs. I would say to 
these doubters, try the small doses often repeated and your 
faith will revive. Take the first child you l;ave in your 
practice with catarrhal fever or croup, and give it fourth 
or half-drop doses of aconite in a teaspoonful of water, re- 
peated every ten or fifteen minutes, and you will see the 
lever driven oft' and disappear like frost before the summer 
sun. But there is an advance yet to be made and a point 
reached when we shall exclude all save the active principle 
of drugs. Quinine is far preferable to the bark, morphia 
to opium, and why should not the alkaloids and their salts, 



Periscope. 207 

aconitin, veratrin, hyoscyamine, strychnine, digitalin, er- 
gotin, and others, given in small doses (1-120 or 1-160 grain 
of the more potent) at short intervals — every quarter or 
half hour or hour — and discontinued or given at longer in- 
tervals when relief is afforded, be far preferable to the 
large and oftentimes nauseating compounds which are so 
frequently prescribed ? The thanks of the profession are 
due and should be extended to advanced pharmacy for ren- 
dering it possible to administer medicines in forms which 
are not only accurate and reliable, but in many instances 
pleasant to the eye and to the taste of both children and 
adults. We cannot afford to allow a blind and foolish pre- 
judice against what is called homoeopathy to prevent our 
welcoming any advance which may tend to remove skepti- 
cism and restore faith in our healing art, and at the same 
time render our remedies palatable and pleasing alike to 
the taste and to the eye. A writer in a recent number of 
The Lancet says: "No man who has ever used aconitine for 
the reduction of temperature will hark back to the tinc- 
ture, Fleming's though it be, or any crude form of the drug: 
and he who has not used hyoscyamine in trouble of the 
hollow viscera — stomach, bowels, bladder, etc. — has yet to 
experience the satisfaction and joy with which he will be 
greeted after prescribing it for a patient with spasm, re- 
tention, dysentery, or hernia; for this last is often spared 
the surgeon's knife by this beneficent drug." The wise 
physician is he who has learned to choose the quickest and 
the best remedy for the relief of his patient, unmisled by 
superficial differences; who can shun the rocks where others 
have been wrecked, or fi'om foresight of what is coming 
can be cool when the peril is upon him. — Dr. Dixon in 
Louisville Med. Xeics. 



Iodoform in Phthisis. 

Dr. Dreschfield, from an experience of this agent for 
over six mouths (by inhalation and pills— one grain per 
dose — mixed with creosate and dextrine), reaches these 
conclusions: 1. It is well borne, producing no nausea or 
gastric irritation. 2. By its ansesthetic properties, it re- 
lieves throat irritation and cough, especially in incipient 
phthisis. 3. In some cases it increases digestion and appe- 
tite and relieves vomiting. 4. It reduces slightly tempera- 
ture where this is raised." 5. No bad results have followed 
the inhalation. 6. HBemoptysis is not a contraindication, 
having entirely disappeared in some under its administra- 
tion. 7. It seems to arrest the disease in its incipiency. 
—Id. 



20S The Peoria Medical Monthly. 

Iodoform Dressing in Vienna. 

Dr. Roswell Park, writing to the Annals of Anat. and 
Surg. (July) says iodoform is used in the Vienna hospitals, 
to the exclusion almost of every other dressing. All the 
great surgeons have settled down into pretty much the 
same routine in using it. The part to be operated upon is 
scrubbed with soap and carbolized water and then carbo- 
lized again. The requisite operation is then done. All the 
instruments are laid in carbolized water, the sponges also, 
and before dressing the wound is thoroughly irrigated with 
a 3 p. c. sol. It is then dressed with iodoform gauze instead 
of the Lister gauze, with no intervening protective. Over 
the gauze is usually placed a moderately thick layer of ab- 
sorbent cotton, and then something corresponding to the 
Mackintosh laid over this. The whole is then closely and 
neatly bandaged; the bandages used being quite wide and 
made out of a strong gauze. If advisable the wound may 
be dusted with powdered iodoform. In subperitoneal am- 
putations it is dusted iii many cases under the peritoneum; 
in osteoplastic resections, between the ends of the bone, 
and after extirpating tumors, many sprinkle it upon the 
inner surface of the flaps. The drainage tube is much less 
resorted to now than under strict Listerism, there being 
much less suppuration, and the discharge being more of a 
serious character. Elevation of temperature demands a 
change of the dressing; pain, burning and itching may also 
require it, but they are rare, as iodoform has anodyne prop- 
erties, and are largely the result of tight or improper ban- 
daging. As an antiseptic it must rank ahead of carbolic 
acid, and it promotes absorption more rapidl}^ than any 
other medicinal agent. The author thinks that it should 
become in America, as it is there, the antiseptic of the 
present and immediate future for general use, until some- 
thing: better ofters. 



Oplitlialniic Aphorisms. 

Dr. J. J. Chisolm, of Baltimore, gives the following 
valuable aphorisms in a report presented to the Maryland 
State Medical Society at its last session: 

First Aphorism. — Do not blister. In fortj-nine applica- 
tions out of fifty, as I find it used by physicians at large, it 
is an additional and useless torture to the eye disease from 
which the patient is already suffering. 

Second Aphorism. — Do not use nitrate of silver. As 
constantly prescribed by general practitioners, it is not 
beneficial in one case out of one hundred, and therefore is 



Periscope. 209 

a very painful infliction to the ninety-nine who would have 
been so very much better off without it. 

Third Aphorism. — Do 7tof prescribe sugar of lead. In 
every case zinc, tannin or alum is better, and then there is 
no fear of having insoluble deposits incorporating them- 
selves with the exposed surface of corneal ulcers. 

Fourth Aphorism. — Always use iveak solutions of the 
mineral and vegetable astringents in the treatment of eye 
inflammations which attacK the mucous surfaces, and re- 
strict their application to conjunctival diseases exclusively. 
One grain of alum, sulphate or chloride of zinc, sulphate 
of copper or nitrate of silver, in an ounce of water, will in 
the majority of cases of conjunctival diseases, do much 
more good and give much less uneasiness than the very 
painful five and ten grain solutions which are so often in- 
juriously prescribed by physicians. 

Fifth Aphorism. — Solution of the sulphate of atropia, 
from one to four grains to the ounce of rose water, is an 
essential eye-drop in the treatment of acute iritis, to break 
up newly formed adhesions. One drop of the atropia solu- 
tion in an inflamed eye is a most valuable means of estab- 
lishing the diagnosis, whether iritic complications exist or 
not, and should be used in most cases of eye inflammation 
to find out whether there are any adhesions of the pupil to 
the lens. 

Sixth Aphorism. — Eserine in solution of one grain to the 
ounce of water is the remedy for purely corneal lesions. 

Seventh Aphorism. — When physicians are in doubt as 
to the character of an eye disease, they should seek a con- 
sultation from specialists who are more familiar with eye 
diseases than general practitioners can possibly be. Such 
timely aid often saves the patient a lifetime of trouble. 

If physicians would commit to memory and keep at 
their finger ends, and ready for use, these simple aphor- 
isms, the amount of mental and bodily suffering wdiich 
they will prevent in their eye patients is beyond calcula- 
tion. While all good rules have necessarily many excep- 
tions, they may safely follow their simple guidance. — 
Columbus Medical Journal. 



Treatment of the Placenta after Abortion. 

Dr. Stanley P. Warren, of Portland, presented a prac- 
tical paper on this subject at the late meeting of the Maine 
Medical Association, in which he classed abortions under 
four heads, advocating primary extraction of the placenta 
without leaving the result to nature, observing, of course, 



210 The Peoria Medical Monthly. 

all proiDer p.recautions with reference to shock and hem- 
orrhage. 

Glass 1. — Sudden flooding, cervix open, %evere shock, 
and it is unknown whether the placenta has been expelled 
or not. 

Class 2. — Moderate hemorrhage; the foetus has recently 
been expelled; the cervix open and the placenta within 
reach; general condition good. 

Class 3.-^The fcEtus has been expelled for some days; 
the secundines are retained ; the lochias are fetid and 
some form of septic inflammation is present in the pelvic 
cavity. 

Class 4. — There has been more or less flooding; foetus 
has been expelled; cervix is closed, and the placenta can- 
not be reached by the finger; general condition good. 

Cases w^ere cited illustrating each of these divisions, 
and facts presented as to the subsequent condition and la- 
bors of these patients. 

For the first class the doctor recommended procedures 
which should relieve shock and check hemorrhage, and as 
.soon as reaction was well established the contents of the 
uterus, if an}^, should be removed. 

In the second class there seems to be no question as to 
the propriety of immediately evacuating the uterus, if the 
placenta is free and can be removed tvitliout pyeUmitmyy 
d'dataiion of the cervix. It is to be regarded as simply a 
foreign body. There is less danger of injury to the tissues 
with the finger than with the curette; it also has the ad- 
vantage of the sense of touch. The curette, on the other 
hand, causes less pain and may be used with or without the 
speculum; has not found the ovum forceps as safe as the 
curette, still less than the finger, and ought to be used very 
cautiously in the uterine cavity. 

In the third class, where we have present or impending 
some metritis' no good reason olitains where the uterus 
should not be, within 24 hours, relieved of its contents and 
thoroughly cleaned ; the cervix is usually patent and re- 
quires no dilation ; a dull curette, followed by intra-uterine, 
not carbolized, injections, will accomplish every desired 
object in the way of removal. The quicker the focus of 
infection is taken away, the less is reparative action de- 
layed and septicemia to be expected. 

In dealing with class third, when the fetus is expelled, 
but the placenta shut up in the uterine cavity, obstetricians 
must choose whether they will "do nothing," relying upon 
rest and opiates, or mechanically dilate the cervix, per- 
haps, with a sponge tent, and, as they say, ''let nature take 



^ Periscope. 211 

its course/' or they maij remove the placenta within twenty- 
four hours after the expulsion of the embryo, using dila- 
tors for some hours before operating, or dilating with the 
finger and immediately extracting. 

On these points of procedure the most distinguished ob- 
stetricians and gynecologists in the countrj^ differ. 

It has been urged in objection — 

1. It is UD necessary, since the vast majority of pa- 
tients do well if let alone. 

2. It is the finger, curette, or forceps that does the 
damage, rather than the retained placenta. 

3. It is very difficult, perhaps' impossible, to remove an 
adherent placenta, and septicemia can be caused by a pla- 
cental tuft as surelj^ as by the entire organ. 

To these objections the Doctor replied : 

1. These tonic contradictions are essential to the arrest 
of hemorrhage ; there cannot be tonic contractions until 
the placenta is expelled, and the less will he the hemorr- 
hage existing or possible. 

2. Anxiety in both the patient and physician will be 
prevented by early completion of the abortion. 

3. Time is gained in uterine involution.' 

4. Absorption of putrilage from retained secundines is 
unquestionably the most frequent sequel in abortion; when 
the uterus is thoroughly disinfected, septicemia is evidently 
imaginery. Possible accidents from manipulation are not 
a sulficient reason for permitting a placenta to be removed 
by decomposition, ignoring the fact that self-imprisonment 
must lie imment ; by early removal, therefore, of the pla- 
centa, septicemia is prevented. 

5. Clinically, after abortion, metritis can rarely be 
traced to direct mechanical violence. If lesions have oc- 
curred in the process of extraction, infection in an empty 
uterus, must be slight when compared with one in which 
the entire absorbing surface is exposed and covered by a 
decomposing placenta. — Phil. Med. News. 



Advice to Young doctors. 

Avoid all such tricks as assuring a timid patient you 
will not lance his boil, merely wish to examine it, and then 
suddenly do what you assured him you would not do. 
Veracity should ever be your golden shield. 

The white and the black, the rich and the poor, the 
courtezan, the outlaw, the swaggering rowdy, and the rep- 
robate, will all be represented in your practice. Attend 
anybody if you must, but, seek to avoid disreputable places 



212 The Peoria Medical Monthly. 

and persons : they are more likely to be a curse than a 
blessing. Remember always that such people respect no 
doctor who does not respect himself. 

Endeavor to establish and maintain a complete pro- 
fessional influence over all patients you attend, for without 
their faith and respect you will have to contend not only 
against the physical, but also the mental. 

Be exceedingly cautious about taking patients to be 
visited clandestinely, or having married women or young 
females consult you secretly at your office ; also of attend- 
ing a patient for a disease under pretense that it is some- 
thing else, in order to shield or deceive friends or relatives. 

Do not over-visit j^our patients. Excessive attention 
and numerous visits are rarely appreciated. If you can 
get the reputation of not paying any but necessary visits, 
it will be a special feature in your favor, and will almost 
double your practice. 

A good rule, the only proper rule, is to visit your patient 
when, and only when, you think he really needs your care, 
whether once a da}^, or once in seven days. Nover go 
several times a day without pointing out to them the 
necessity for it. 

Above all else, avoid running in to visit patient un- 
necessarih^, because you '' happen to be in the neighbor- 
hood."' If you visit on such a plea, and charge for it, you 
will be criticised and your bill may be disputed. 

Some well-to-do, or over-solicitous people, form an ex- 
ception to this rule, and insist on your visiting them fre- 
quently, almost living at their house during sickness, to 
observe progress, instruct attendants, etc., regardless of 
the additional expense, and of course you should gratify 
them, but you should, also, at the beginning inform the one 
who will have to pay the bill, of the reason and expense of 
the extra visits, and get his acquiescence. • 

During these frequent visits you should maintain a 
strictly professional attitude; unless you do so, they will 
certainly lose confidence, after which you will be shorn of 
your influence and reckoned a mere cipher. 

Make it a study to remember all that is said or done 
at each visit, so that all you say and do throughout the 
case may be consistent, and also to take care neither to ex- 
pose a want of memory nor a lack of interest. Were you 
to ask a patient, "what kind of medicine did I give you 
last V he. and his friends would notice it instantly and 
think you either felt but little interest in his case or had a 
dangerous lack of memory. 

Earnestness and interest shown in cases are master 



Periscope. 213 

^ualities. They are often actually accepted in lieu of 
kill, and are always prime aids. Imbue yourself with 

genuine interest in your cases, and you will be sure to 

show it in a thousand ways. 

When visiting a patient, always let it be known 

whether you will visit him again, and when ; it will not 

only satisfy him, but will prevent all uncertainty. — '^The 

Doctor Himself]'^ hy Dr. Cafhell. 



Adinimstratiou of Belladonua to Childreu. 

In a lecture delivered by Dr. Jules Simon at Hospital 
des Enfants Malades, he speaks of the uses of belladonna 
in diseases of children. 

He details four cases of whooping-cough in which he 
used it successfully. The hrst patient was a boy three and 
a half years old. to whom he gave, on the first day, thirty 
drops, second day forty drops, and third day sixty drops of 
the tincture. This last dose was continued for ten days 
without bad results, and with considerable improvement 
in the disease. In the second and third cases, fifty to sixty 
drops were given per day, the patients being three and 
four years old. In a girl of thirteen the dose was gradually 
increased to 120 drops daily, with no bad effects. 

He graduates his dose according to the age. giving five 
to ten drops per day when the child is from two to -three 
years old, ten to twenty when, three, and twentj' to forty 
when four years. Below the age of two years it is seldom 
used. The powder and extract maj^ be well combined to 
make a small pill. The sulphate of atropia maj^ be given 
to a child of two years, in doses of half a milligramme, 
gradually increasing to two milligrammes daily. Ext. 
belladonna combined with ext. henbane and oil of hen- 
bane, as an ointment, is useful in arthritis and coxalgia. 
For relief of muscular pains sulphate of atropia and ben- 
zoinated lard is useful. In speaking of its physiological 
properties and therapeutical indications, he describes it as 
an irritant to the parts to which it is applied. Taken 
internally it causes dryness of throat, with bitterness and 
acridit}^, sometimes giving rise to semi-parah'sis of the 
pharj'nx, and even dysphagia. It causes hyper-secretion 
from intestinal mucous membrane, hence diarrhoea, being 
antagonistic to opium, but like it, it causes nausea and 
vomiting in poisonous doses; in such doses it also increases 
the temperature and produces febrile accidents. 

Transpiration is not increased, but the renal secretion 
is, this being again antagonistic to opium. It is supposed 



214 The Peoria Medical Monthly. 

to render the brain anemic, while opium causes congestion 
of that organ. In poisonous doses it produces tetanisra, 
but when correctly used it diminishes the susceptibility of 
the sensitive nerves and calorihcation. 

The author thinks it indicated in simple acute laryn- 
gitis, stridulous laryngitis, mucous cough, spasmodic and 
paroxysmal bronchitis, bronchial adenopathy, whooping 
cough and influenza. In these diseases he used it mostly 
with equal parts of tincture aconite. He recommends its 
trial in nervous little girls of hysterical nature, suffering 
from gastralgia, dyspepsia, and vomiting, when other 
methods have failed. 

In the abdominal neuralgia with constipation, from 
which children sometimes sufl'er. In tenesmus and noc- 
turnal enuresis, he uses an ointment. To establish and 
relieve painful menstruation, he applies an ointment of ext. 
belladonna and henbane to hypogastrium, covering it by a 
cataplasm. In epilepsy he prescribes atrophia for two 
weeks followed by strychnia when the bromides fail to 
cure. In zona and facial neuralgia, it relieves pain, and it 
is of great use in other nervous affections, as also in affec- 
tions of the eye. — North Carolina Medical Journal. 



Whence Originated the Doctrines of Hahnemann ? 

Dr. Oliver Wendell Holmes, in a late lecture, in the 
Boston Medical Journal, in- answer to this question, says 
that lately in looking through the Ortus Medicinse of Van 
Helmont, Elzevi's edition, 1(552, he noticed an odd looking 
prefix, Butler, to one of the chapters. He says: I found 
that this was the name of an Hibernian, a great personage 
formerly, as he represented, at the court of King James the 
First, of England. At present, however, this distinguished 
stranger was provided with lodgings at the public expense 
in the jail of Vilvoorden, a tow^n of Belgium. Here it w^as 
that Van Helmont, a very credulous, very whimsical man 
of genius, a believer in the sympathetic ointment and other 
nonsenses of the kind, became acquainted with the dis- 
tinguished stranger, who bore the family name of the Duke 
Ormond. The captive wrought some wonderful cures 
wdiich Van Helmont reports. The first case was that of a 
monk suffering from erysipelas. The Irishman dipped 
a pebble quickly into a teaspoonful of oil of almonds, and 
instantly withdrew it. The patient took some of the oil 
and was cured at once. Second case: a washerwoman, 
complaint hemicrania. He dipped the same pebble quickly 
into a teaspoonful of olive oil, gave it a lick with his 



Periscope. 215 

tongue, and put it back into his waistcoat pocket. He 
poured that teaspoonful of oil into a small vessel of oil. 
One drop of this he rubbed on the old woman's head. Im- 
mediate and permanent cure. Stupefied astonishment of 
Van Helmont. to whom the son of Erin, '"My darling, if you 
don't get on so far that you can cure any disease with a 
single remedy, you will remain a greenhorn till you are a 
greybeard." The next patient was a nobleman; a bad case 
of gout, as it would seem. He was to touch the pebble 
every morning with the tip of his tongue, w^ash the lame 
part with a cheap lotion prepared in the laboratory of 
nature, and be well in three weeks. If he will make me 
well, says the count, I will pay him his own price, and , 
deposit so that he shall be sure of it. Our friend with the 
pebble takes this in high dudgeon; he will never help the 
miserable creature; does not want his money; is as good as 
he is. Van Helmont could not prevail upon him to treat 
the case and became skeptical. But not long afterwards a 
fat friend of his w^anted to be rid of his obesity. Butler 
gives him a small piece of the pebble which he is to lick 
once or touch swiftly with the tip of his tongue every 
morning. In three weeks he was a span narrower about 
the chest. Van Helmont begins to have faith again, and 
being himself ill, as he thinks from poison, sends a flask of 
oil to Butler, who is still in jail, and who dips his pebble in 
it. One drop to be applied externally in one or more 
places. Entire failure of relief. Skeptical once more — our 
inquiring philosopher. But next, his wife is relieved of a 
dropsical swelling, and the servant maid of an ill-cured 
erysipelas, and a widow of a stiff arm, all by one or more 
drops of the oil, and an abbess of loss of power in her right 
arm by only touching her tongue to the pebble. Then I 
asked Butler, says Van Helmont, "Whj^ so many women 
were cured at once, while I at sword's point with death and 
full of pains in all my joints and organs got not the slight- 
est relief." The Irishman gave a plausible answer, which 
silenced if it did not satisfy the learned simpleton. 

Thus the essence of the infinitesimal doctrine is in this 
most curious chapter of the Ortus Medicinse. Hahnemann 
mentions the name of Van Helmont in his Organon and I 
have little doubt that he borrowed his infinitesimal doses, 
smelling of remedies and other inventions from this 
chapter. 

Van Helmont entirely anticipated Hahnemann in in- 
sisting upon the use of simple remedies. " I believe," he 
says^ "that simple remedies in their simplicity are equal to 
the cure of all diseases, and consequent!}^," he adds, " the 



216 The Peoria Medical Monthly. 

dispeiisaries, wishing to compound and correct many in- 
gredients, lose everything, and by a hidden blasphemy, as it 
were, undertake to supph' the divine insufficiency." 
Where Hahnemann got his third great doctrine, that itch 
is the cause of seven-eighths of chronic diseases. I do not 
know^ but I notice that Van Helmot has a good deal to say 
about that disease, from which he himself suffered for many 
months, and what he says may very probably have set 
Hahnemann thinking about it. 

Thus it appears that as early as the middle of the 
seventeenth century the essential doctrines of Hahnemann 
were promulgated and that Hahnemann must have been 
familiar with them. 



To be Copied Into the Practitioner's Xote Book. 

Inhalation of five to ten drops of amjd nitrite will 
break up a chill of malarial fever ; so will hypodermic in- 
jection of one-sixth of a grain of muriate of pilocarpine. 
It is said that twenty drops of oil of turpintine will con- 
trol the diarrhoea of typhoid fever. Two to five drops of 
wine of ipecac, three times a day, will, in the majority of 
cases, check the vomiting of pregnancy. — Independent 
Practifioner. 



Telephonic Troubles. 

Mistakes may happen even in the "best regulated fami- 
lies. Here is an example : Chicago is blessed with a 
druggist of great experience, and staid, modest habits of 
demeanor. It is his custom to replendish his stock when 
necessary, by ordering by telephoue from other houses in 
the same line of business. AVith this purpose in view he 
called up such a house, and supposed he had it, when in 
fact he was still speaking to the telephone office. He was 
overwhelmed with chagrin and shame when in reply to 
his question, ''Have j^ou large black nipples ?" only a hearty 
soprano cachinuation was returned from the female opera- 
tor in the office. For a numlier of days thereafter he was 
compelled to repeat his blushes as he caught the lady's 
laughter whenever she heard the tones of his voice on the 
wire. 



Torsion of Arteries. 

At Guy's Hospital the London correspondent of the 
Boston Med. and Surg. Journal says that all the surgeons 
use torsion to the exclusion of the ligature, except in very 
small vessels wherein it is difficult to isolate the vessel 
from muscular fibers. They give a very large statistical 



Periscope. 217 

showing ill its favor. He ha^ seen every kind of amputa- 
tion there except of the hip-joint, and never a ligature ap- 
plied to a large vessel. They use no transverse forceps, 
but, seizing the cut end of the vessel with strong forceps, 
twist it until it is felt to "give way ;" that is, the two inner 
coats break. He has often seen six and sometimes ten 
complete turns given to the femoral ai-tery. Mr. Bryant 
said : "Doctor, theoretically the twisted end ought to 
slough off, but practically it never does. We have to talk 
to our students about secondary hemorrhage, but we do not 
show it to thf m." Mr. Lucas told him that tor a long time 
they had ceased to dread or look for secondary hemorrhage. 
— Chicago Med. Berie}). 



Nerve-Stretching' — Vreter Stretching-. 

The London Medical Record quotes from the Deutsch 
Med. Wochenchrift, a letter which gives a ''fling" at the 
nerve-stretchers. The writer speaks of ureter-stretching 
for granular kidney! He has also stretched the hepatic 
duct for cirrhosis, and intends to stretch not only the pneu- 
mogastric nerves, but also the bronchi for chronic contrac- 
tion of the lung ! He also asks, "Might not general 
paralysis of the insane be cured by simple extraction of 
the teeth, and stretching of the respective twigs of the 
dental nerves ? 1 will try it. A new era is dawning ! 
Here is. indeed, an art. and. while we live, let ns stretch !*' 



3Iartin's Adhesive Plaster iu Umbilical Hernia. 

A cheap, expeditious, light and effectual supporter for 
an umbilical hernia, as suggested by Dr. Roberts in 
Bryant's Surgery, is made as follows : A plug of bees-wax 
the size of the hernia, and abroad strip {\l in.) of Martin's 
adhesive plaster, are all that is necessary. The hernia is 
reduced, the wax plug placed in position over the outlet. 
and the plaster carried around the bod}' and over tlie plug. 



Traumatic Tetanus Treated Successfully by the Sulphate of 

Eseriue. 

We had forgotten to notice this encouraging case con- 
tained in the pages of our valuable contemporary, the New^ 
Orleans Medical and Surgical Journal, March, 1882, until 
it came again to our notice in the Bulletin de Therapeu- 
tique. The case was in the person of a child 11 years of 



218 The Peoria Medical Monthly. 

age, three weeks after a wound in the foot. The ])roinides, 
chk^ral, and cannabis were tried without eftect. Eserine 
was adniistered in doses of 1 milligramme (about 1-100 
gr.) from hour to hour. The dose was diminished as the 
symptoms amended. In a week three grains of sulphate of 
eserine were administered, the child recovering. 



Note on Excessive Sweating- of the Feet. 

Having had occasion to treat a number of cases of ex- 
cessive sweating of the feet, in one case accompanied by 
fretidity, the following treatment has apparently given con- 
siderable relief : 

The patient is directed to immerse his feet morning 
and night, for about ten minutes, in warm water at 115 deg. 
to 120 deg. F., in which a teaspoonful (1 drachm) of pow- 
dered commercial soda (impure carbonate of soda) is dis- 
solved. The feet are then thoroughly dried, after which 
they are painted all over with a coating of comp. tiiict. of 
benzoin, which acts as an antiseptic, astringent, and by its 
mechanical presence on tlie skin. This treatment is con- 
tinued for about ten days, after which it is practised once 
daily, or every other day, as the necessities of the case may 
require. — MarijUotd Med. Journal. 



Syphilitic Infection of the Finger by Medical 3Ien. 

Prof. Fessenden N. Otis, M. D., communicates to the 
Indepvndent Practitioner of March, particulars of eight cases 
of sypliilis contracted by physicians in making digital ex- 
amination of the vagina3 of syphilitic women. The initial 
lesion of this form of syphilis is described as l)eing uni- 
formly a papule, "coming soon to be of a deep red color, 
and presenting a superficial abrasion, becoming circular 
and deeper by a slow molecular necrosis; not by ulceration 
with formation of pus; the secretions thin and serous, and 
drying into a scab, which is soon displaced by the fluid ac- 
cumulating underneath." He also remarks '"the entire 
absence of induration: in its place a slight, fiat, juic}"- 
looking, boggy swelling, or elevation, about like a small 
peppermint in size and thickness." 

As proof of the efiicacy of treatment, which was con- 
tinued in five of the cases for one and a half to two and a 
half years, he states that subse(iuently "eight healthy chil- 
dren have been born, and both they and tne parents have 
continued free from any evidence of syphilis." — Med. atal 
Sury. Jonrnal. 



Therapeutic Notes. 



2\^ 



D? DTSrEI-f^IA WITH ACID ERUCTATIONS ! IN HEAKT-BURN AND ACID ERUCTATIONS. 



AND DEBILITY. 

3J Ammt'n. carbonat,|[ 5 grains. 

Tinct. auranti. 1 drachm. 

Infus. chirtteee, 1 ounce. 

Aquae, 2 ounces. 

Make a draught to be taken night 
and morning. — )Vcstrrn Med. Reporter. 
Or: 

5 Sodse bicarbonat, 1~0 grains. 

Spts. amnion, aromat, 1 draclmi. 

Tinct. zingiberis, 1 ounce. 

Infus. gent, co., S ounces. 
Mix. A sixth part three times a day. 
—I hid. 

CA-MPHOR.^TED CIILORO-TANNATE OF 
IODINE 

Is the name given by Dr. Q. C. Smith, 
of Austin. Texas, to the following prep- 
aration which is used as a tonic appli- 
cation of bleeding ulcers and cancers 
af the cervix uteri : 
IJ Chloral hydrate, 1 drachm. 

Iodine, I2 drachm. 

Oil of camphor, 4 drachms. 

Dissolve and add sufficient tannic 
acid to bring the mixture to the consis- 
tence of a thick syrup. — Se>uth Proc. 

INJECTION FOR SCIATICA. 

Lereboullett recommends in cases 
where morjihia is badly liorne the fol- 
lowing solution for hypodermic injec- 
tion — 

I^' Morph* hydrochlor, ij grain. 
Atropia? sulph., l-(j grain. 

Aqu* destillat, 212 drachms. 

Ten to fifteen minutes every six 
hours. — Uiiioa Med.; London Prat-. 

TREATMENT OF PHAGEDENIC ULCERS- 

Dr. Vidal, in Concours ^Medical, rec- 
(jmmends — 

5 Vaseline, 10 draclims. 

Pyrogallic adid 1 drachm. 

M. Make into an oiiument and ap- 
ply morning and evening. — Med. and 
iiury. Rep. 

INCONTINENt E OF URINE. 

For incontinence of urine in children. 
Dr. Janeway, in X. Y. Medical Record, 
recommends a coml)ination of ergot, 
belladonna and iodide of iron. We 
suggest the following formula — 
i^ Tinct. Ergot, 2 drachms. 

Tinct. Belladonna, 1 drachm, 

Syr. icxlide iron, 1 ounce. 

Simple elixir, 1 drachm. 

M. One teaspoonful morning, noon 
and bedtime 10 a child 10 years old. 



The following lozenges are superior 
to the officinal bismuth lozenges — 
^ Bismuth subnitrat, 720 grains- 

Magnesiie carbonat, 2 ounces. 

Calcis carbon, prsecipitat, 3 ounces. 

Sods bicarbonat, 1,800 grains. 

Sacchari albi, 14 ounces. - 

Acaciic gummi, 220 grains. 

Mucilag. acaciae 1 ounce. 

Divide into 860 lozenges, and dry 
them with a moderate heat. From one- 
to six lozenges mav be taken at a does.. 
—Ibid. 

IODOFORM IN ULCERS. 

Dr. Wade, in Detroit Clinic, says: In 
the treatment of ulcers, the cause, if 
possible, being otherwise removed, I 
have found no other application to 
equal the followiijg: 

Take of — 

Iodoform, powdered, 30 grains. 

Sub-nitrate of bi.smuth, 60 grains. 

Chloral. hydrate, 15 gi-ains. 

Glycerine. 2 ounces. 

Oil of rose granium, 10 drops. 

Water to make, 3 ounces. 
Mix and write. Shake and apply. 

PURPURA. 

R Vin. feiri, 4 ounces. 

Liq. arsenicalis, 10 minims.. 

Syr. zingiberis, 2 ounces. 

M. Sig^ One-sixth part, witli three- 
tablespoonful of water three times a 
day, after meals. — Med. Oaz. 

DYSPNCEA OF PHTHISIS AND EMPHYSEMA.. 

E Ext. stramonii 3 grains 

Ext. hyoscyami 20 grain 

Ext. liipuli 40 grain 

M. and divide into nvelve pills; one- 
to be taken every four hours until re- 
lief is obtained. — Med. 6az. 

GELSEMIUM IN RHUS POISONING. 

D]'. Edsou reports in the Medical 
Record, July 29th, a local application, 
for rhus poisoning ; 
R Acid carbolic, ^.^ drachm. 

Ext. gelsemii, fi, 2 drachms. 

Glycerinse, '^■'2 ounce. 

Aquae, 2 ounces. 

M. The pain speedily subsides; the 
burning, itching, corroding sensation, 
ceases ; within 36 hours the disease is^ 
effectually killed, and the progress to< 
direct recovery is direct and rapid. 



Txi: 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor anil Publisher, 

204 South-Jefferson Street, .... PEOKIA, ILL. 

*♦* All exchanges, books for review, ami communications must be addressed to the 
Editor and Publisher. 

***Tlie publication day of this journal is on or about the lOtli of each month 
**jr'Vo subscribers! A pencil mark at ihis place indicates that tlie time of your sub- 
scription has expired, and that a prompt lenewal is urgently requehted. 



Professor Edward W. .Jenks, M. 1>., L. L. D. 

Although a Western man. Dr. Jenks has but recently 
moved to this state and perhaps is not as well known as 
his merits deserve, for this reason we have thought that a 
short sketch of his life might be of special interest, es- 
pecially to our Illinois reader*. 

Born in Ontario County, New York, in 1833, he moved 
with his father to Indiana in 1S43. His early edu(?ation 
was gained at the La (Irange Institute and from private 
tutors. His medical education was received at the medi- 
cal department of the university of New York, at the Cas- 
tleton Medical College in Vermont, where he graduated in 
1855, and at the Bellevue College in New York from which 
he received the ad ciiikIoh degree in 18(U. In the latter 
year he renio\'ed to Detroit. Mi(diigan. While in Detroit 
he was for four years an editor of the liiricir of Medieuw 
and Professor of Obstetrics and Diseases of Women in the 
Detroit Medical College and president of the faculty. Dur- 
ing part of this time he lectured during his vacations on 
the the Surgical Diseases of Women in Bowdoin College, 
Maine. In 187^) he was chosen to succeed Dr. W. H. By- 
ford as Professor of Cynecology in the Chicago Medical Col- 
lege, which chair he held until a few months ago. 

Among many other soiuety connections which Dr. 
Jenks has formed we may mention that he is a correspond- 



Editorial Department. 221 

ing member of the Gynecological Society of Boston, fellow 
of the Obstetrical Society of London, the Cincinnati Ob- 
stetrical Society, and the American Gynecological Society, 
of which he was one of the founders. 

Dr. Jenks has written no extended work upon the sub- 
ject of his labors, but the papers he has written for the so- 
cieties and journals, mark him as one of the most pleasing 
and thorough writers in the country. Indeed, so exhaust- 
ive are his contributions to Gynecological literature, each 
monograph is fitted to stand as a complete chapter in the 
future Encyclopedia of Gynecology. x\mong the most im- 
portant of these papers we might mention: ""The Causes 
of Sudden Death of Puerperal Women." " Perineorrhaphy, 
with Special Reference to its Benelits in Slight Lacera- 
tions and a Description of a New Mode of Operating," 
" The Relations of Goitre to the Generative Organs of Wo- 
man." " Atresia," "The Treatment of Puerperal Septicaemia 
by Intra-Uterine Injections," *' Coccygodynia." and the last,, 
'' The Practice of Gynecology in Ancient Times." In con- 
cluding this hearty sketch we shall append a short article 
from the Michigan Medical Ncics. as showing the esteem in 
which Dr. Jenks is held in his old home of Detroit, and out- 
lining his future work: 

We are very much pleased to learn tliat our former 
townsman Dr. E. W^. Jenks, who recently resigned the Pro- 
fessorship of Gynecology in the Chicago Medical College 
has put into execution a plan which w^e have known him 
to have long entertained, viz.: the establishment of a pri- 
vate hospital for the treatment of the diseases of womem. 
The location of this hospital is at Geneva, Illinois, and the 
institution will be known as "Springbrook." A large circle 
of friends, both professional and lay. in this city and state, 
who were cognizant of Professor Jenks' intention to with- 
draw from tlie Chicago Medical College for upwards of a 
year before he tendered his resignation, had indulged the 
hope that he would return to this city where there are so 
many considerations to entice him. He has found, how- 
ever, that with the relief from the onerous duties which 
devolved on him in connection with the Chicago ^ledicai 
College his health has sufficiently recuperated to perniit of 
his carrying out the long cherished scheme above indicated 
and he wiirremain in Illinois, holding regular daily office 



222 The Peoria Medical Monthly. 

hours in Chicago and returning each daj^ to the Sanitarium. 
His well earned reputation as a gynecologist and his ex- 
tensive acquaintance are suthcient to guarantee the suc- 
cess of his new enterprise from the veiy beginning. 



Obituai-y. 

Dr. Josiali R. Snelling was the son of General Snelling 
U. S. A., the fouilder of Fort Snelling. which still bears his 
name, between St. Paul and Minneapolis, Minn. 

At this place Dr. Snelling was born about fifty-five 
years ago. He received a good preliminary education, 
and graduated at Rush Medical College. 111.. February 7th, 
1850. After practicing a few years in the western part of 
this state he removed to Peoria about twenty j'ears ago, 
where he resided until his death. 

A very quiet, retiring, almost diftldent man. Dr. Snell- 
ing never attained a large practice, and many of the best 
years of his life were spent in a struggle to support and 
educate his family of four daughters. Those who became 
intimately acquainted with him found him to be a man of 
wide reading, an excellent memor}'. and courteous wit, and 
such will greatly deplore his death. He was elected 
County Physician of Peoria County a number of times and 
gave general satisfaction, as was evinced by his numer- 
ous re-elections. 

His death had been poor prior to his death. Sept. 13th. 
1882. but he was only confined to his house about three 
weeks. The cause of death, as proven by a post-morten 
examination, was chirrhosis of the liver. The Peoria 
Medical Society passed the following resolutions of respect 
to the memory of the deceased : 

Whereas. We are again called upon to record the 
death of a collegue. be it 

Resolifd, That in the death of Ih\ J. R. Snelling the 
medical profession has lost a worthy and useful member, 
his family a kind and affectionate father, and this city a 
faithful citizen. 

Resolrnl. That the sympathies of this society l)e ten- 
dered to the daughters of our late friend, and that we will 
at all. times do whatever may be in our power to promote 
their welfare and comfort. 



Editorial Department. 223 

Resolved, That the members of this society attend the 
funeral in a bod}% and that a copy of these resolutions be 
given to the daily papers and placed on the records of this 
society. Robert Boal. M. D., 

H. Steele, M. D.. 
T. M. McIlvaine. M. D. 

Committee. 



N'otes and Coninients. 

Dr. Cummings has removed from Moravia, Iowa, to 
Centerville, Oregon. 

Dr. T. E. Webb, formerly of Shelton, Xeb., has located 
at Carbon, W3^oming Ter. 

Dr. W. H. Smethers has changed his address from 
Moline, Kan., to Topeka, Kan. 

Dr. J. A. Clutten has removed from Terre Haute, Ind., 
to Benton, Franklin County, Illinois. 

The British army in Egypt will use "blue goggles." 
25,000 having been ordered for use. Wonder how they 
will match the "Red Coats?'' 

•• What would you do sir." asks Punch, " If you were 
called to see a man wdio had hung himself?" " I would cut 
him down." Then what would you do?" "I would cut 
him up.'' 

In the October issue we will print a letter from a prom- 
inent dentist on the subject. "Dental Plagarism. or Amal- 
gam Poisoning." It contains some startling statements, 
and will prove very interesting reading. . 

Twenty- five county societies of New York have so far 
expressed themselves on the " new code," of these twenty- 
four have directly repudiated it. This is nearly unani- 
mous, but in the other direction from the prophecy of the 
Beconl. 

An Irish woman needing some silk and tape sent her 
husband for them. The silk was shown, but the buyer 
thought the price too great. The clerk explained that all 
silk goods were dear owing to some disease at that time 
prevalent among silk-worms. The tape was next exam- 



224 The Peoria Medical Monthly. 

ined, and Mr. Irishman thought that, too. a little stift* as to 
price. "And, indade, sir,'' says he, "is there likewise a 
dezaze a prevalin" among the tape-worms." — Obsfefric 
(ildZfffc. 

The forty sets of <!harts received and sent out the past 
week were not enough to go all around. More are 
expected dail}^, and will be forwarded at once. We thank 
our friends for the patience exhil»ited, and ho^je they will 
be pleased with their charts. 

A physician fell into a tit while making his round of 
visits and is carried into a drug store. *'Send for Doctor 
X.'* says somelwdy. " Xo. no.*" says the dying man feebly 
at the mention of his rival's name, "It he brought me 
round it would advertise him. I prefer to die."' 

How the Electric Medical Journals do howl about "Allo- 
pathy ! '" Some of them take up about all their space in 
tighting the ghost which they themselves set up. Would 
it not Ije be better if these journals would devote more 
space to the healing art and less to such rediculous fan- 
faronades ? 

The MSS. works of the physician (lalen, which were 
supposed to be lost, have been discovered in Salonica by a 
M. Papageorges. They dated from the fifteenth century 
and appear to have originally formed 24S sheets : 144 are in 
good condition, twenty-four are mutilated or worm-eaten^ 
and eighty are missing. 

According to the phraseology ot a local paper, a man 
in Minnesota recently died from what was pronounced to 
be leprosy by "physicians of the most hideous appearance." 
The latter are probably the kind of medical men referred 
to in an advertisement, quoted liy us some time since from 
a Southern paper, for a " Second hand doctor's buggy." — 
Colleye und (Jlifttticn] Jicrord. 

The Eighth Annual Meeting of the Tri-State Medical 
Society will be held at Terre Haute, Ind., September 26th,' 
27th and 2Sth. We regret that space will not permit the 
printing of the programme in full. It comprises some 
fifty titles of articles to be read, and is as interesting a 



Editorial Department. 225 

"bill of tare" as could be furnished by ain' society. The 
papers are limited by rule to twenty-five minutes, and some 
to tifteen minutes. Reductions have been secured from 
the railroads, also from hotels. Those intending to be 
present are requested to notify Dr. J. E. Link, Terre Haute. 
Chairman of the Committee of Arrangements. The offi- 
cers of the society this year are : Dr. J. M. Holloway. 
Louisville, Ky.. President : Dr. G. M. Burton. Mitchell. Lid.. 
Secretary : Dr. F. W. Beard. Vincennces. Lid.. Treasurer : 
Dr. Wm. Porter. 8t. Louis. Mo.. Chairman of Committee of 
Programme. 

A well-known medical man of this city was called up 
by telephone the other day, when the following conversa- 
tion took place : '" It has come doctor."' The doctor 
thought he knew the voice, and, wondering why he had 
not been sent for, shouted back : " Is it all right V "It's 
a very small pattern." answered the voice, which was that 
of a woman, '" Imt it will do if we take pains." The doc- 
tor caught the last word, and called distinctly : (live it 
paregoric ?" The was a munil)led discussion which he 
could no hear, and then the voice called : "Ts this Doctor 

r No ! Ifs Doctor of Fort street." Then he 

heard a chorus of mirth, and was informed that he was in 
communication with a fashionable dress-making house and 

it was a silk dress for Doctor s' wife that was under 

discussion, and that he was the wrong man. which, under 
the circumstances, was rather a relief to the Fort street 
physician. — Da ill/ Paper. 

The report just received of the Observatory at Yale 
College, shows that more than double the numl^er of phy- 
sicians' thermometers were tested at that institution last 
year over the year before. So great errors have been found 
in some instances, that hereafter the phj^sician w4io reports 
an extreme of temperature w^ill be in duty bound to report 
whether or not his thermometer is a reliable one. One 
instrument was found that was four and oii^'-JiaJf tlef/rers 
out of the way. 

Public opinion has already reached the point when it 
demands that the physician shall have a thermometer; it 
will not be long when it will require that his thermometer 
be a tested one. A case that recently occurred in the 



226 The Peoria Medical Monthly. 

writer's practice will serve to illustrate the fact that the 
hand is, under certain conditions, a veiy poor test of tem- 
perature. We were called hastily to see the patient of 
another physician, during his temporary absence. The 
patient was dying. The pulse was 240 per minute, and the 
tem])erature 1<)() degrees in the axilla, hij a iprified flier- 
monieier. The attending physician came in just as the 
instrument was being withdrawn, and. after examining the 
patient, expressed the opinion that the temperature was 
siih-iiornud. He is a skillful practitioner, and never 
depends upon his temperature sense, knowing too well how 
fallacious it is. The patient died within an hour. — Cohnn- 
bii.s Med. J())ii-))(i]. 

A medical society has Ijeen organized in (rrundy county, 
with Dr. A. F. Hand, president: Dr. A. E. Palmer, vice presi- 
dent: Dr. S. J. Ferguson, secretary: and Dr. A. D. Smith, 
treasurer. It will. pro]iaV)ly. unite with the Will county 
society soon, as l^oth societies are anxious tor such 
a union, and will then have about forty members. 

Certificates of practice entitling the holders to practice 
medicine and surgeiy in Hlinois. have been issued to the 
following named practitioners, bv the State Board of 
Health: 

E. L. M. Bristol. M. D., Chicago, Illinois ; diploma of Jetterson 
Medical College, Philadelphia, Pennsylvania. 

Albert Beasley, M. D., (rrand Tower, Illinois ; diploma of Missouri 
Medical College, St. Louis. ^lissouri. 

Julius H. Dietrick, M. D., Chicago ; diploma of Swiss Medical Col- 
lege, Zurich, Switzerland. 

Albert DeLiplay, M. D., Chicago ; diploma of ^Medical Department 
Fniversity of Michigan, Ann Arbor, Michigan. 

William A. Johnston, M. D., Peoria ; diploma of Medical De])art- 
ment University of Pennsylvania, Philadelphia, Pennsylvania. 

Charles H. McGorray, M. D., Chicago ; diphjma of ^ledical Depart- 
ment University of Michigan, Ann Arbor, Michigan. 

A. J. Mclntyre, M. D., Thompsonville, Illinois ; diploma of Medical 
Department University of Michigan, Ann Arbor, Michigan. 

Patrick McCambridge. M. D., Springfield ; diploma of Missouri 
Medical College, St. Louis, Missouri. 

J. M. Patton, M. D., Oak Park, Illinois : diploma of Medical De- 
partment University of the City of New York. 

Isaac N. Kuddell, Charleston, Illinois ; diploma of 3Iedical Depart- 
ment University of Louisville, Kentucky. 

Thomas C. Rivers, M. D., Chicago; diploma of Medical Department 
University of Louisiana, New Orleans, Louisiana. 

Ernst P. Raab, M. D., Highland, Illinois : diploma of Medical De- 
partment University of Pennsylvania. Philadelphia, Pennsylvania. 

M. M. Robinsju, M. D., Entield, Illinois ; diploma of Kentucky 
School of Medicine, Louisville, Kentucky. 



Editorial Department. 227 

M. F. Spalding, M. D., Kimmswick, Missouri ; diploma of St. Loui.s 
Medical College, St. Louis, Missouri. 

Carl. F. Sandberg, M. D., Chicago ; diploma of Christiana Univer- 
sity, Js^orway. 

Dr. H. Saguin, Amboy, Illinois ; certificate of twenty-four years' 
practice. 

Dr. John A. Simmerman, Lane, Illinois ; certificate of twenty-seven 
years' practice. 

Edward K. Tyler, M. D., Illinois City, Illinois; diploma of the 
Medical Depa.itment, Iowa State L'niversity. 

Frank A. Wyanet, M. D., Pullman, Illinois ; diploma of the Medi- 
cal Department University of Michigan, Ann Arbo.T, Michigan. 

David A. White, M. D., Oak Grove, Illinois ; diploma of the Ohio 
Medical College, Cincinnati, Ohio. 

Charles F. White, M, D. Wayne City, Illinois ; diploma of the Mis- 
.souri Medical College, St. Louis, Missouri. 



Receipts. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months past 
adopted the plan of printing in this place the name of those 
from whom money has been received during the preceding 
month. Those remitting will please note whether their 
names are included in the lists, and if the}' are not will 
notify us by card : 

Illinois. — Drs. Lee Smith, A. L. Brands, D. S. .Jeuks. F. \\. Bullock, J.R. 
Baker, J. P. Jolmson, I. S. Hughes, B. F. Harris, L. L. Leeds, Ed. Swisher, D. TV. 
Aldrich, A. E. Warren, C. Shrader, R. P. .Jennings, E. L. McKinnie (2 years), F. 
M. Casal (2 years) S. D. Culbertson, G. B. Garrison, L. E. Keeley, A. M. Van 
Derslice, G. E. Luster, .J. H. Wallace, Hon. Thomas Cratty, Drs. X. E. Ballou, 
W. T. Williams. D. P. McClure, P. E. LaBarriere, Thomas A. Horrine. D. W. 
Magee, H. T. Hardy, W. D. Karns. W. H. H. King, .7. Paine. W. F. O'Brien. W 
C. Bj-ington, A. G. Humphery. L. W. Carter, C. D. Henton, F. G. Steever. A. L 
Craig. .J. W. Hensley. A. W. Edmiston. 

Iowa — Drs. .J. A. Scroggs, W. H. Davis, .J. R. Miller. .J. M. Schee. R. W 
Huston, A. H. Connett, H. C.jVanWerden. .J. E. & T. P. Stanton, .J. Roberts, J. S. 
Ormiston, .J. C. Williams, John A. White, O. E. Evans, H. C. McCoy, B. M. Tor- 
rey, R. L. Boon, J. Richardson, H. L. Cokenower, W. H. Merritt, J. M. Randall 
C.H.Hamilton, J. W.Eckles, S. R. Bergen, William Ott, S. P. Black. D. H .- 
T\'orthington, -J. D. McVay. 

MixxESOTA. — Drs. S. C. McCormick, F. H. Welcome. I. .J. Stone, E. A 
Holmes. 

Kextuckt. — Drs. .J. Ed Ray, O. H. Buck, R. H. .J. Davidge, Stirman & 
Stirman, .J. G. Brooks. .J. A. Farabrough, R. .T. Howard, C. H. Hubbard, J. L. 
Owens. 

Missouri. — Drs. W. A. Monroe, .1. K. Lusk. J. W. Dunlap, .T. Seever-;. 

Pennsyi.vania. — Dr. J. K. Park. 



228 The Peoria Medical Monthly. 

Akkansas.— Dr. P. i). Hooper, W. J. Pinson. P.. W. Lind;-ley, W. C. Mont- 
gomery. 

Wisconsin.— Drs. .J.C.Hall, J.J. Sherman, J. M. Boyd, J. "NV. Cnainber- 

Missiseu'i'i. — i)r. J. J. Gage. 

Wkst ViH<iiNiA. — Dr. S. L. Barber. 

Indiana. — Dr. G. W. Carpender. 

Nebraska. — Drs. S. W. Dodge, O. C. Keynolde. 

MirHiOAX. — Dr. A. iiarwood. 

Inhian Tkruitory. — Dr. H. W. Fannin. 

Kan8a* — Dr. J. Leiirli. 



Wanted. 

A regular jiiiYsician to lake a good country practice. No heller anywhere. 
Write or call at once. Must sell by (October 10th. Only .$1-50 wanted for the 
practice and office building. 

Watson ct 3Ii Kennan, Druggists. 
New Holland, Logan County, Dlinois. 



Sonic Thiuj^^s That 3Iay Interest You. 

I liave used S. H. Kennedy's Concetraled Extract Pinus Canadensis in some 
atfections of the rectum, vagina and cervix uteri. I have used it considerably 
diluted, as a viginal wash, with great success; but I prefer to apply it to the os- 
tincte on cotton avooI, either pure or mixed with gljcerine, or glycerine and rose- 
water. Thus applied it should remain intact for two or three, or even four days 
and then be renewed. In this way I have seen chronic granular vaginitis reme- 
died in a few days that had resisted the ordinary remedies for weeks; and have 
seen granular erosicms, with leucorrh<L'a. disappear very rapidly under its use. I 
have not time to do more than call the attention of my professional brethren to 
this new extract, which I am sure will soon lie recognized as a valualtle addition 
to (mr Materia Medica. J. Marion Stms, M. D. 

2'i7 .Madison Avenue, New York. — From the Medical Gazette. 

St. Lotis, MissoiRi. 
I freijuently prescribe Cei.erina when I want to use a reliable compound 
of celery and coca, and the prescriptiim has given me satisfaction in its results 
as a nerve Ionic in many cases. Yours very truly, 

' C. II. Hk^hes, M. D. 
Lecturer on Psychiatry and Neurology, Post-Graduate Faculty, St. Louis 
Medical College, Editor Alienist and Neurologist, etc. 

The art of sugar-coating pills so as not to impair their solubility, but to pre. 
serve the composition, keeping it .soft and plastic, has acquired for Messrs. War. 
ner& Co. a world-wide rei)Utation. Physicians may rely upon the purity of the 
drugs Used, and upon the mathematical nicely in which their pills, "granules,' 
and "parvules" are divided. Every doctor may be his own druggist, and at the 
same time save himself the drudgery of it by using WAHNEK'S preparations. 
A li<)ttle of Quinin% Pills recently sent us by this firm .satisfies us that this tirm is 
fully maintaining iir^ it-putatioi!. — A'^ri'/i C'irulina Medical JuurnaL July, 1871». 



The Peoria 
MEDICAL MONTHLY. 



Vol. hi. OCTOBER, 1SS2. No. 6. 



(Drigiual (f^0mmuuicatiau,5i. 



Art. I. — Dental Plagarism. or Amalgam Poisoning. Its Origin and ^His- 
tory.— By I. PAT^-E. D. D. S., Dwight, 111. 

My attention has just been called to an item in the 
last issue (August 1SS2) of j^our journal, under the caption 
of "Mercury Used in Dentistry," to which I wish to say a 
few words in reply. The author of the item referred to, 
holds out the idea that the discovery of this peculiar kind 
of poisoning belongs to him. As a matter of simple jus- 
tice, allow me to say that whatever credit there may be 
in the discovery of the fact that amalgam in the teeth 
produces chronic poisoning and is ruining tens of thou- 
sands of people, is my personal pyoperfij, the discovery 
having been made by me so long ago, that the period at 
which it was made antedates the time when the waiter 
above referred to was wrapped in swaddling clothes. 

It is some thirty-eight years since I commenced agi- 
tating this question. It was when I first ascertained the 
composition of amalgam that I made the statement to a 
dentist that such material was liable to poison the patient, 
but he said it was impossible. I then asked him if he 
knew how calomel was made? He said he did not. Then 
I asked him if he knew how corrosive sublimate was 
made, and again he gave me a negative answer. Then I 



230 The Peoria Medical Monthly. 

said, "How do you know that amalgam plugs in the teeth 
will not poison the patient?" He said, because he knew it 
wouldn't. I then explained to him the process by which 
the poisoning was liable to take place. I said that when- 
ever mercury and chlorine came in contact at common 
iemperatures, a combination takes place and the result may 
be calomel, or it may be corrosive sublimate. " Now," I 
said, "the fluids of the mouth contain chlorine and more 
than half of common salt is chlorine, and now that he had 
placed in the teeth the other element (mercurjO and the 
mouth would become a chemical laboratory for manufac- 
turing corrosive sublimate, one of the most deadly of all 
metallic poisons." I said furthermore that the process 
would be so slow and gradual that the symptoms would at 
first be so slight as not to attract attention. This was my 
theory and some years afterward I wrote an article on the 
subject, and entered minutely into all the details of the 
symptoms that would follow that peculiar kind of poison- 
ing. I showed how the patient would gradually go into a 
decline and would for a long term of years slowly w^aste 
av>^ay, and that there would be nothing whatever to guide 
the medical practitioner in forming his diagnosis as to the 
nature of the trouble. I even went so far in that paper as 
to say there would be a brassy taste in the mouth, and 
that water would flow from the mouth in the night, while 
asleep, so as to wet the pillow. I also stated that the 
metallic taste would not he constant, as the plugs would be 
liable to become oxidized or turn black, and when that 
took place the metallic taste would stop for the time, or 
be diminished until the crust formed by the oxidation was 
rubbed ofi" by brushing the teeth ; or otherwise, when the 
chemical action would again be revived, and again the 
patient would be poisoned. I advised the medical practi- 
tioner when he had a case where the patient had gradually 
gone into a decline without an}' apparent cause, and when 
the case did not respond properly to medical treatment^ 
and thus baffled his skill, I advised him under these cir- 
cumstances, to examine the teeth for amalgam plugs- 
And I said if there was amalgam in the teeth, and if there 
was no metallic taste at the time, and the plugs were 



Original Communications. 231 

black, that if the doctor would scrape one of the plugs 
bright, and direct the patient to put the tongue to the 
plug, if it then produced the metallic taste he might rest 
assured that his patient was poisoned by the plugs, and 
that the removal of the plugs and the use of antidotes for 
poisoning from corrosive sublimate, such as raw eggs, 
would restore the patient to health. It is more than a 
quarter of a century since I wrote the article setting forth 
the above facts, for all of which I was only ridiculed and 
laughed at. It is true, it was then only theory; I had 
never seen a case such as I had described. 

But in 1867 my theory was fairly put to the test, and 
the truth of what I had written was practically demon- 
strated, and all the facts precisely as I had detailed them 
w^ere brought to light. I was then and had been for a 
long time a practicing dentist in St. Louis, Mo. One day a 
young lady was brought to my of&ce to have some teeth 
filled. She was in very poor health and as frail as a 
morning glory. She was under treatment of a prominent 
medical professor of St. Louis, who was completely baffled, 
as he could get no possible clue to the cause of her long 
illness. 

Her story was, that some seven years previous to the 
time I saw her, she had gradually commenced declin- 
ing and had continued to do so ever since, without any 
apparent cause. A good while before this time I had 
found that the amalgam question was destined to get me 
into a war with my brother dentists, nearly all of whom 
were using it extensively, and as it was only theory with 
me, I had thrown it aside and quit talking about it, and 
had dismissed it from my mind. The lady continued to 
call on me occasionally for dental operations, and she still 
continued to grow more and more feeble, and although I 
knew she had amalgam in her teeth, and though many of 
her symptoms seemed to be familiar to me, yet without 
knowing how they should be, it never occurred to me that 
she was a victim of the peculiar kind of poisoning that I 
had long before described in my written article. I had, at 
our first acquaintance, made the statement that some hid- 
den agent was undermining her constitution and was 



232 The Peoria Medical Monthly. 

gradually sappino^ the vital powers, and that if her physi- 
cian could ascertain the cause of certain symptoms which 
I mentioned, I thought it might lead to her recovery, and 
she bore a message to this effect from me to her doctor, 
but he treated it with indifference. Many months later, 
seeing that she was gradually failing, and seeing that 
additional symptoms had made their appearance, at my 
suggestion she again requested her doctor to try and ascer- 
tain the cause of these new symptoms, but as before, he 
turned a deaf ear to all such entreaties. Strange as it 
may seem, it was then arranged that I should undertake 
an investigation of her case myself, but why T should step 
outside of my regular line of business and undertake a 
case that I knew nothing about, was something I could not 
then, nor cannot to this day understand. I only know 
what I did and the results that followed. At my request 
my efforts were to be strictly confidential and the family 
phj^sician was to know nothing of the matter. The first 
step I took was to engage a professor of chemistry to assist 
me, and the professor had several interviews at my office, 
lasting through several hours each time, in which he would 
ask all manner of questions, to ascertain, if possible, the 
channel through which the agent had entered the system, 
that was destroying her. After one of these protracted 
interviews he would go home and consult his authorities, 
and then hold another interview ; and in this way weeks 
were consumed, l)ut he too like her other medical advisors 
was completely baffled, and finally said he ''had reached 
the end of his rope," and abandoned the case in despair, 
and on doing so requested me that in case I got any light 
on the subject to call and see him. 

A few days after the professor left me, while still run- 
ning through my mind various theories as to the cause of 
the strange symptoms, all of a sudden the question of 
amalgam poisoning flashed through mj^ mind, and every- 
thing was explained. I immediately had the lady brought 
to my office, and the answers to a few questions verified 
the conclusion to which I had arrived. The course I now 
pursued was exactly in accordance with w4iat I had many 
years before pointed out in what I had written on the sub- 



Original Communications. 233 

ject. I inquired of her how long the amalgam had been 
in the teeth, and her answer showed that it corresponded 
about with the time she had been out of health, and by 
eircumstances which she called to her aid, she fixed the 
time exactly, and then she remembered that previous to 
that time her health had been excellent; but began to fail 
soon afterwards. In reply to my question as to the brassy 
taste in her mouth, she said she had been troubled a great 
deal with it, but did not have much of it that day. At my 
request she took the operating chair, and I said I would see 
if I could produce it. and on scraping one of the plugs 
bright, which was badly oxidized, I requested her to put 
her tongue to the plug, and in doing so her face was d]-awn 
into contortions like biting a green persimmon, and hold- 
ing her head over the spittoon, w^ater flowed from her 
mouth in a stream, as if she had been salivated. It was a 
very clear case, and to convince her that I was right, I 
then produced the old paper that I had written, and there 
she saw that all of her main symptoms had been minutely 
detailed fifteen years before. I then dismissed her without 
taking out the plugs, a thing that I greatly regretted ever 
afterwards, as it came near costing her her life. About 
midnight that night she was taken with violent symptoms, 
and they sent for the doctor, and when he arrived he found 
her in great agony and suffering from a violent attack of 
dysentenj, which was to him another great mysteiy, as 
there was no apparent cause for such a disorder, and as I 
had still enjoined secrecy on the part of the patient and 
her friends until such time as I was willing to have it dis- 
closed, they kept their word faithfully, and the doctor was 
consequently in the dark, and he told me afterwards that 
he thought she would have died before morning, in spite 
of all he could do. Early next morning I was sent for to 
go to the house and take out the plugs, as the lady was 
very sick and unable to leave her room. On calling at the 
house, her friends assisted her out of bed and into the sit- 
ting room, wdien I removed the fillings, l^eing careful not 
to let any particles touch her tongue or mouth, and in five 
minutes after the plugs were removed she was better. I 
hen told them to send for the doctor and tell him all 



234 The Peoria Medical Monthly. 

about it, and to put her on the treatment of antidotes for 
poisoning from corrosive sublimate, and she would get 
well. This time he followed my directions and the lady 
rapidly recovered, and he frankly stated to the family that 
I had saved her life, and that if it had not been for me she 
would have died, and he never would have known the 
cause of her death. 

There is an important point in this case that ought 
not to be lost sight of. Owing to the peculiar constitu- 
tional condition of this lady, her idiosyncrasi/, she was ren- 
dered highly susceptible to the action of mercury, and 
during her long and constantly failing health, it was a case 
of slow or chronic poisoning; but when I scraped the plug 
bright and left it in her mouth, in consequence of her sus- 
ceptibilitj^, it w^as no longer a case of slow^ poisoning, but 
had assumed the acute form and had brought on the dysen- 
tery, as the doctor found. By reference to works on 
Medical Jurisprudence and also works on Poisons, such as 
Christian, Taylor and others, it will be seen that in the 
acute form of poisoning from corrosive sublimate, one of 
the leading symptoms is chjsentery. The two plugs taken 
from this lady's teeth, w^hich I still have in my possession, 
weigh less than four grains. 

I had supposed that another case like this would not 
likely be met with in a whole lifetime, where a patient 
was so susceptible to the influence of mercury as the one 
in question, but in this I was mistaken. In another case 
that came into my hands, the patient was pronounced hj 
several physicians to be in the last stages of consumption, 
and there was every indication to warrant the diagnosis. 
This lady, too, was very much reduced and barely able to 
walk, and her cough and other symptoms seemed to leave 
no doubt of her case being consumption. Having occa- 
sion to extract a tooth for her, I discovered a number of 
her teeth filled with amalgam, and knowing that mercury 
would produce consumption, my suspicions were immedi- 
ately aroused, and I began to interrogate her, as I did the 
other lady, and it proved to be another case of amalgam 
poisoning. As in the other case, the plugs in this instance 
were highly oxidized, and in making my tests, I scraped 



Original Communications. 235 

one of the plugs as before, and left the plug in the tooth, 
and she too was taken violently sick between midnight and 
daylight, and they had to call in their doctor, and in the 
morning sent for me to go to the house and remove the 
plugs. This lady had always enjoyed the best of health 
until after the teeth w^ere filled with amalgam, and shortly 
afterwards her health began to fail. Her first symptoms 
were fainting fits, and the first one she had she fell in the 
street. This is one of the leading symptoms of poisoning 
from small quantities of mercury. The next symptom was 
sickness of the stomach and loss of appetite and gradual 
wasting away, and finally the cough set in and was so bad 
as to throw her into spasms. All these symptoms, and 
many more, continued to increase in force for seven or 
eight years, until she was a complete wreck. At least a 
dozen doctors had seen her, and they said she could not 
possibly live a year. I assured her that all of her sickness 
came from the amalgam and that she would recover. It is 
now more than ten years since I removed the amalgam, 
and she is not dead yet, but on the contrary, got married 
and has several children. 

Now, we have in these two cases this caution : Never 
to scrape one of the plugs bright and leave it in the mouth 
over night. When the brassy taste annoys the patient by 
daytime they can spit, but while asleep late at night this 
poisoned saliva all goes into the stomach. Now it is often 
the case that these plugs get loose and are swallowed. There 
is not the least doubt in my mind but that a great many 
of the violent deaths that are met with are caused just in 
this way. I have weighed some of these plugs that weighed 
thirty grains, and at least two-thirds of this was mercury. 

Now, if certain chemical combinations take place in 
the stomach by which less than one-fourth of this mercury 
is converted into corrosive sublimate, the patient has a fa- 
tal dose and is liable to die with all the symptoms of dys- 
entery. If the quantity generated is a little larger, then the 
symptoms will resemble those'of cholera, and if the cholera 
is about the patient would be treated for that disease, while 
at the same time he is dying from the effects of an amal- 
gum plug in the stomach. But I care not whether the 



'236 The Peoria Medical Monthly. 

plug undergoes any chemical change at all. It is in an oxi- 
dized condition, and mercury when oxidized is ahrai/s prjis- 
onous. And we may regard it in still another light. It is 
liable, and in fact almost certain, to become vaporized, and 
that means pewali/sis, shakifirj-palsij, the same as is experi- 
enced among the manufacturers of looking-glasses, etc., 
and a long list of other maladies too numerous to mention 
here. The man who has amalgam in his teeth has a minia- 
ture quicksiher mine in his mouth, and the mouth becomes a 
reduction u-orks for extracting the metal from, its connection 
with the other component parts. 

And the dentist who mixes and rubs the amalgam in 
the palm of his hand, as they all do, is rubbing into his 
blood a subtle agent that will undermine his constitution, 
and, before he is aware of it, will steal away his health ; 
and hence we see at the dental chairs all over the country 
puny, weakly, pale, hump-shouldered, narrow-chested, di- 
lapidated specimens of humanity, that havn't strength 
enough to pull a tooth, and numbers of them dying of par- 
alysis and consumption. But I am digressing, and must 
return to the history. 

Some ten days after the amalgam was removed from 
the teeth of the St. Louis lady, the facts were published in 
full in the St. Louis Democrat, June 6th, 1867, and so widely 
copied by other papers that I was written to from various 
cities of the United States, by dentists and others, congratu- 
lating me on the discovery I had made and the benefits 
that would accrue to the public. 

[to be continued.] 



Art. II. — Congenital Frbromatous— Lipoma of the Foot.— A Paper read be- 
fore the McLean County Medical Society by S. T. Anderson, M. D., Bloom- 
ington, 111. 

Gentlemen: — You will remember the lad who was 
present at our last meeting for advice concerning an ab- 
normal growth upon his foot. 

I may say of this abnormality, that it was congenital, 
and originally included the second and third toes, the nails 
of which were imperfectly developed, and presented on the 
under surface of the terminal phalanges. These nails, to- 



Original Communications. 237 

gether with a slight depression along the dorsal aspect, 
gave the only evidence that the two toes were enveloped 
in the unnatural casing. About three years since the toes 
were removed, but a portion of the pathological structure 
was allowed to remain. This had developed about in pro- 
portion to the growth of the patient — who is now seven 
years old — and, projecting beyond the metatarso-phalan- 
geal articulation, presented an extremity of globular ap- 
pearance, and somewhat larger than a goose's egg. 

It's dorsal attachment appeared to be about the mid- 
dle of the second and third metatarsal bones, and it's plan- 
tar terminus about the base of the bones above named. 

When the lad came before the society various opinions 
were given as to the nature of the growth and the best 
method for its removal, and among the latter choparfs 
operation was named. The fear of hemorrhage was enter- 
tained if an attempt should be made to dissect the tumor 
from its attachments. This danger, I am informed by Dr. 
Lackey, was feared by the surgeons at the time of the prior 
operation, they believing the growth to be possessed of 
great vascularity. Fortunately this was not true to the 
extent suspected by these gentlemen. However, the ap- 
prehension of free hemorrage was not entirely unfounded, 
for if the deeper parts of the growth should enclose the 
plantar arch, or lie in close relation thereto, some difficulty 
might be experienced in so conducting the dissection as not 
to wound the arch or its more important branches. Some 
days after seeing the boy, Dr. Wm. Hill, of this city, pro- 
posed that I should join him in an attempt to remove the 
tumor without amputating the foot, and I readily assented. 
After Dr. Reedy had gotten the patient anaesthetized, Es- 
marck's bandage was applied and the operator commenced 
by an incision on the dorsal surface, drawn from between 
the second and third metatarsal bones, and about their 
middle, extending obliquely outward to near the fourth 
toe, and along the plantar surface to a point corresponding 
with the commencement of the incision. A second incision 
was then made corresponding to the first, only that it was 
drawn toward the great toe, and thence toward the ter- 



238 The Peoria Medical Monthly. 

minus of the first line, so as to include a large oval mass 
intended for removal. 

As the dissection began the mass appeared as if pure 
fat on the dorsum of the foot, but soon denser tissues were 
encountered which cut almost like cartilege, while numer- 
ous fibrous bauds gave a greater degree of adhesion than 
we had anticipated. No blood was lost during the dissec- 
tion, but afterward we found it necessary to ligate several 
arteries, especially on the plantar surface. The fibrous 
bands in this locality penetrated deeply and were in inti- 
mate relation with the plantar arch and the communica- 
ting branch of the dorsalis pedis. We were obliged to draw 
the tissues well forward and carefully detach the growth. 
The large piece which I show you weighed five ounces. 
Besides this, a number of small pieces were removed, but 
not preserved. 

Concerning the name of the formation, let me premise 
this: Every tumor should have a name corresponding to 
the predominant tissues found therein. Tumors should be 
named as we name diseases. For example, we have typi- 
cal typhoid fever ; we also have a typhoid state to which 
seems added malarial phenomena, and hence we speak of 
" Typho-malarial fever." 

Well, we found a large amount of fatty tissue, yet did 
we follow the eminent Dr. Gross, we could not say we had 
a lipoma, for this authority says fatty tumors may occur '* in 
any part of the body, with the exception, perhaps, of the 
palms of the hands, sole of the foot, the fingers and toes." 
Other eminent men declare that lipomata may occur cou- 
genitaUy in the location where this one was found. I pre- 
fer to be guided by the rule I have just given. 

In summary, the microscope revealed, 

1st. Abundant pathological fat. 

2d. Fibrous bands of great and lesser density. 

3d. A small number of cartilege cells in certain locali- 
ties. 

Conclusion : As fatty and fibrous structures predomi- 
nate, we have o. fihromatoiis-lipoma, or, if you like a plainer 
name, ^ fihro-faitxj tumor. 

Results of operation excellent. 



J' Original Communications. 239 

Art. III.— a Case of Congestion and Induration of the Mammary and 
Axillary Glands, Presenting some Peculiar Features: Treatment and 
Recovery. By G. W. Carpender, M. D., Soulli Bend, Indiana. 

March 13th, 1S82, I was called to see a Mrs. B., who had 
heen an invalid about ten months. Having passed under 
treatment of two or three of our well informed physicians 
and given up as a case beyond their knowledge either to 
diagnose or help. I found her suffering with her breasts 
and left arm. The breasts were atrophied, and had very 
much the appearance of hemlock-tanned sole leather, dried 
and hard, and fully attached to the costal integuments. 
The left nipple was sore and very sensitive; could not bear 
to have it touched. About two inches below it was a large 
(what appeared to be) mole, black and ugly to look at. 
The left arm was swollen two or three sizes and full of 
pains and aches, and appeared to contain water, and could 
be raised only about to an angle of twenty degrees. In 
the axilla there was, deep down in the fossa, a hard sub- 
stance bearing the feel of a schirrus the size of a butternut. 
The face was dark, sullen and shrunken, with some 
cachectic appearance. Yet I did not like to believe her 
disease to be cancer, though it had been so called by some. 
In studying the case I found that about eight .years ago 
she had a broken breast on her right side, and had not en- 
joyed very good health since; was subject to congestive 
chills, and ten months previous to my visit had had two in 
close succession, and from them had arisen the sequals I 
had found. I pronounced the case to be congestion and 
induration of the glands, both mammary and axillary^ 
followed by a stoppage of the veinous circulation and al- 
trophy of the breast, and dropsy of the arm was the lesion 
to be overcome. The indications of cure were, first, 
dismiss the induration and thereby restore the circulation 
of the veins; and secondly, invite the blood to the cuta- 
neous and other tissues. 

I began by the use of hot air and vapor (administered 
in one of E. E. Hacknej-'s constructions, of this place), 
maintaining the heat at 160 degrees Far. for twenty-five 
minutes, three times a week. Cleansed the prima-via with an 



240 The Peoria Medical Monthly. w 

emetico-cathartic oiDeration, and locally applied over the 
breast and arm a wash prepared of sul. acid, alcohol and 
olive oil, followed by a plaster of glycerine and starch or 
flour. The acid, alcohol and glycerine having such an 
aflinity for water, called to the parts that essential. After 
a few weeks the skin put on a more healthy appearance, 
but yet the swelling not disappearing from the arm I 
applied to the axilla a plaster of chloride of zinc, arsenous 
acid and flour for ten days causing a deep slough; sus- 
pended the arm in a sling, raising it to an angle, or about 
45 degrees above the horizon for about eight hours out 
of the twenty-four, keeping mostly in bed. This treatment 
with an occasional laxative and diuretic with anti-periodic 
treatment has so far accomplished the work that the arm 
is reduced to almost natural size. The altrophied parts 
are movable and filling up with a lively flesh appearance. 
The mole has sloughed out: the nipple has shelled off and 
healed; the schirrus came out about the size of a half 
orange, and the general complexion is as good as most 
people. She can now use her arm to dress her hair, with 
every prospect of full recovery. I still keep the axilla 
open, and am continuing treatment. To keep open the 
sore I have used chromic acid, sul. zinc and acid arsen. 

In this hasty and brief way of preventing a very diffi- 
cult case I have necessarily left out much that was auxil- 
ary to the success, and such as perhaps would not meet the 
indications of another case. 

In a case of such type I consider the prime indications 
of cure to be toward the skin, and I have never been able 
to meet such without the use of hot air and vapor, and for 
my use the Hackney bath has been the best, as it meets all 
the indications at very small expense, and can be kejDt con- 
veniently in one room of a physician's office or house. In 
an experience w^ith it of five j^ears, during which time I 
have had occasion to administer such treatment thousands 
of times, 1 am led to recommend to my brethren her 
cabinet, and I think no physician has the whole armor of 
his iDrofession without one. 



Original Communications. 241 

Art IV.— a Peculiar Case Peculiarly Handled. By F. L. Seaeles, M. D., Hart- 
ley, O'Brien County, Iowa. 

March 4th I was called to E. H. Edwards^ aged nine. 
Found child languid, limbs painful and stiff. Extensor 
muscles of left leg much swollen ; a bright red eruption over 
joins and buttocks ; pulse and temperature normal ; appe- 
tite fair ; bowels regular ; urine contained slight traces of 
albumen ; feet wet day previous ; vaccinated about three 
weeks ago from an aunt's arm. I examined the aunt, whO' 
gave no history of any skin disease. 

When asked for diagnosis I told them not to worry, as 
he was not poisoned from vaccination, and when pressed 
told them a form of rheumatism. Prescribed sodium salicy- 
late 4 grains, and quinine snip. 1 grain, every three hours. 
Spts. eth. nit. and tincture digitalis ; take of each three 
drops every three hours. 

March 5. — No improvement. Muscular swelling of left 
limb extending from hip to end of toes, and beginning on 
the other; eruptions changing, some fading, others turning 
a dark blue, and diffused, somewhat like the ecchymosis 
from a bruise ; bow^els moved naturally : upper lip and 
eyes slightly swollen ; albumen increased slightly, 1-25 per 
cent. The remaining three children had scarletina in Dec.^ 
ISSl. This one felt "dumpish one day." When asked if I 
still thought it rheumatism, I told them it was, but that 
the kidneys were affected and he might have acute neph- 
ritis in connection with his present disease. Clave in ad- 
dition to his previous treatment hydrarg cum creta 3 
grains, pulv. jalap 3 grains, morning and evening. 

During the day a Homoeopath was called in, and I was 
told he diagnosed, " Poisoned by vaccine virus, and the child 
would never get well as it had the bad disorder." Never- 
theless he gave dilute moonshine and came daily for three 
and a half weeks, then he magnanimously gave the boy up 
to die. — A fearful lesson to those who steal their vaccine ; 
also to aunty. 

March 27. — An Eclectic Ji^sculapius was called, who 
noticed "marked cerebral disturbances," and told the pa- 
rents he would leave some medicine and consult with me, 



24:2 The Peoria Medical Monthly. 

so should the boy live to need more treatment I would 
know just what to do. 

He called and informed me the boy was "rotating," as 
the belly of the occipital muscle would puff up, then the 
biceps, and so on down to the feet, a bright red eruption 
coming and going with the swelling, then fading and 
striking in, when the boy would pass bloody mucus from 
the bowels, and each passage attended with tenesmus and 
a frequent desire to go to stool. He diagnosed "cerebral 
spinal meningitis," and gave — 

I^ Tine, nucis vom., 20 drops. 

Tine, aconite, 5 drops. 

Aqua, 4 ounces. 

Sig. — One drachm every 2 hours. Also — 

]J Potas. iodid., 2 drachms. , 

Com. syr. sarsap., 4 ounces. 

M. — One drachm every four hours. 

April 2. — The boy's father came to me and wanted to 
know what to do, as he presumed the eclectic had thor- 
oughly posted me. I advised him to keep on and give the 
last man a chance, " but the improvement was down hill." 

As he plead pathetically I agreed to take charge of the 
case providing there was no further interference made. I 
found the boy much as described by the last doctor, but 
thought uric acid poisoning better than cerebro spinal 
meningitis ; bowels passing much blood and mucus ; little 
water ; puffed up beyond recognition, and no eruption ; 
urine coagulates up solid ; pulse 140 ; temperature 101 ; 
taken no nourishment for ten days ; too weak to lift his 
arm ; slight uremic convulsions ; muscular swelling slight. 
Gave calomel 15 grains and ordered fluid extract jalaj) 20 
drops, twice daily, and continued the nitre and digitalis 
same as in the start. Also — 





5! Tine, ferri clilor., 






1 ounce. 




Tine, nucis vom., 






6 drachms 




Quiniae, 






30 grains. 




Spts. vini gal., 






8 ounces. 


Sig. 


Two drachms every 


four 


h 


ours. 



The above, with the exception of hydrarg. cum creta 4 
grains twice daily was the treatment continued through 
the convalesence. 



Original Communications. 243 

April 3. — "Rotating" again; muscles swelling; erup- 
tion appearing ; bowels moving freely and less blood ; Oe- 
dema subsiding ; pulse 125. 

April 4. — Patient resting better ; mental faculties 
clear ; muscular swelling less than last " rotation ;" urine 
contains less albumen ; bowels still moving freely, no blood; 
oedema much less. 

April 5. — Improving slowly ; taken three ounces of 
milk ; first nourishment for thirteen days. 

April 7. — Patient improving ; sat up in bed to take 
food ; other symptoms improving ; I continued the same 
treatment up to April 21st, increasing and diminishing the 
jalap and blue chalk as needed. The recovery being com- 
plete. No traces of albumen, and patient playing around 
the house. The above is one of eight cases of albuminuria 
from scarlatina here, and all have received nearly the same 
treatment, viz : Tine, iron and quiniae, nitre and digitalis, 
beginning with blue chalk as an alterative. 



Art. v.— Rupturing of Membranes During Labor. B}' .Joseph A. Stites, 
M. D. Physician and Surgeon to Nye Co. Hospital and Prison. Belmont, 
Nevada. 

It has been claimed by authors and teachers that the 
membranes should never be ruptured except by the dilata- 
tion of the OS uteri. If we interfere with this mode of 
procedure, we are then meddling wdth nature. In many 
books it is laid down that we should wait until the mem- 
branes rupture, it makes no difference how long we may 
have had to wait, or how long our patient has had to suffer. 
I would like to ask them, is it right and just that we, as 
professional men, should sit at the bedside and allow^ our 
patient to suffer when we can relieve her, at least can assist 
her in her travail? 

Of course, in some cases I have seen the membrane 
rupture when the patient least expected or anticipated that 
it was going to occur so soon. I am now referring to pre- 
cipitated labors, for we all know that the labor is termina- 
ted long before any assistance can be rendered to the wo- 
man. Of course in a labor of that description it is hardly 



244 The Peoria Medical Monthly. 

necessary to employ a physician, for as a rule when the ac- 
coiicheuer arrives it is all over with. This is one side ; 
now comes those cases where we are compelled to sit and 
wait for the dilatations, and in many cases it is slow and 
tedious work, and each moment seems to be an hour. Slow- 
ly it proceeds until the os has attained the size of a silver 
dollar. At this stage the inferior segment of the mem- 
branes graduall}^ engages in the orifice. The successive 
and repeated contractions cause the liquor amnii to flow 
towards this point and the amniotic pouch becomes tense 
and bulging at its lower part, and being supported by the 
parietes of the neck, it does not give way as it should. 
It remains in contact, a firm, bulging tumor, the surround- 
ing part hot and free from all secretions, and the patient 
suffering, as 1 think, unnecessarily. Oil is then applied to 
lul)ricate the parts, all to no purpose. Ergota is given and 
a severe contraction takes place, as though she was going 
to expel the uterus itself : the child is forced to the orifice, 
the membrane is compelled to rupture, and the child's death 
ensues, produced by this unnatural contraction of the uter- 
us. My plan is, while the neck of the tumor, or this bulg- 
ing pouch of the membrane, is protruding from tlie uterus 
in the vagina, to take my finger, scrape or pierce the mem- 
brane, and so force a rupture. Then the flow of liquor am- 
nii takes place, th« head descends (or w^hatever part is pre- 
senting) and the second stage of labor is then finished by a 
pain or two, and danger of rupture is safely past and our 
woman is spared protracted, unnecessary pain. 

I avoid using ergot, for I have found by experience 
that it is more harmful than helpful, and the risk of endan- 
gering the life of the child too great, for me to willingly 
make use of the drug so unsatisfactory in its action on the 
uterus. The onlj^ benefit I have derived from the use of 
this drug is in cases of lead poisoning, when I have found 
its eff'ects permanent and satisfactory. Besides, ergot 
taken once by a patient in labor, at the next accouchment 
is demanded by the woman and her system. The child 
after passing to a certain strait, nature stands still, and all 
the woman's efforts come to naught, until relieved by ergot 
or the physician adopts some other methods ere the mem- 



COERESPOXDEXCE. 245 

brane is forcibly ruptured. I have found in the parturient 
woman accustomed in previous labors to use ergot, that in 
giving it in this stage it produces such violent contractions, 
even after the expulsion of the child, as to render it impos- 
sible to introduce the hand and bring awaj^ the pla-centa. 
Hoi.rglass contractions and other abnormal contractions 
are momentarily threatened, and do take place, and vio- 
lent means must be resorted to in bringing away the pla- 
centa. All this after trouble is avoided when the simple 
means of forced rupture by the finger is adopted. 



Cont^ljoiuleurc. 



Newport, Perry Co. Pa., Sept. 27, 1SS2. 
Editor Peoria Medical Monti dij : 

On September 17th I was called to see Mrs. S , a 

XDrimipara aged 20, of rather small figure. I saw her at 
9:30 in the evening, patient' said she menstruated for the 
last time on January 19th. She was sitting up and was 
free from pain, had not experienced the slightest uncom- 
fortable sensation, save a fullness in the pelvis. I asked 
her to take her bed, and I made a digital examination, 
found the head in first position, at the superior straight, 
and the os dilated about the size of a silver dollar, but soft 
and patulous. As there were no labor pains and no signs 
of any, and I had waited a whole night not long before on 
a case of the same kind, I concluded to come home and 
sleep awhile. Was called again at 12:30. and when I got 
there the child was born. She informed me that the child 
was born at a single, and the only pain she had the entire 
placenta coming away at the same time. There Avas no 
hemorrhage, the womb contracted firmly. Mother and 
child both strong. 

Dr. Jennings asks some questions. How many jour- 
nals should we take ? A good practitioner is a reading 
man. To say that a man has not time to read, is to say he 
has not time to practice. If a carpenter were to say he 
had not time to sharpen his tools, the results would soon 
be seen. Hence reading is the one thing needful to make 
a successful practitioner. Should we take several medical 



246 



The Peoria Medical Monthly. 



journals ? Yes. But take no more than we can read. 
But take the Peoria Medical Monthly, and study its 
contents. And add a little Anatomy and Physiology to 
our doctorism, do this, and we have done well. 

To what extent shall we patronize new remedies ? 
When we need them, when we want them, then is the time 
to try them. ""Know ye what's the matter? " what's wrong. 
Now correct it, when we have done this, we have suc- 
ceeded miraculously. But we fail to do this sometimes, 
then we should try a new remedy. When we want to ex- 
periment on a new drug, we were told to try it on our 
mother-in-lair first, but we are afraid, and so we try it on 
dead beats. I take up a new drug in this way. I was in 
want for a mixture to hide the bitter taste of Quinia, etc. 
Fl. Ext. Licorice, prepared by Burroughs, came into mar- 
ket, I tried it and it filled the requirements, and I adopted 
it in my practice. But to adopt every new drug placed be- 
fore us, would be like eating victuals because they are on 
the table. What is not needed in the system is injurious, 
let it be cheap as it may. But there is a volume in the 
maxim, *' the fewer drugs, the more recoveries." 

That eminent physician succeeded, and succeeded 
well, who started out with six drugs and a Barlow knife in 
his saddle-bags. Thus he taught the important lesson, to 
be well acquainted with our tools, to understand the prop- 
erties and actions of a drug before we use it, to be able to 
use opium as a cathartic, as an astringent, as an anodyne, 
as a laxative, as a tonic, as a depressant and a stimulant, 
and strive to do a little more than our next door neighbor. 

What attitude to assume toward Homoeopathy ? And 
now, if we have any dignity in us, let us show it here. 
Though we be Washingtons, not allowing a negro to 
exceed us in politeness, using all courtesy, for the people 
soon learn what true professional courtesy is. Let us 
wash our hands, let us be far from the taint. Let us be 
up stairs, and on the door leading from that profession to 
ours, place a^ placard, "No Admittance," showing by our 
walk and conversation that we belong to that which is 
honest, that which is right. Somebody suggest a good meth- 
od for collecting bills. S. Anche Suloff, M. D. 



Book Notices. 247 



On Asthma. Its Pathology and Treatment. By Henry Hyde Salter, W.. 
D., F. R. S., F. R. C. P. Physician to Charing Cross Hospital, Lecturer on 
the Principles and Practice of Medicine, etc., etc. First American from the 
last English edition; 8 vo., cloth ; pp. 284; New York; Wm. Wood & Co. 

1882. 

The treatment of asthma in a general jDractice is too. 
often of an entirely routine character. Not considered 
immediately dangerous in the majority of cases, the phy- 
sician is too prone to attempt nothing more than present 
alleviation, and rest content with the opinion entertained 
by the sufferer that "it can't be cured," or that "it musi 
wear itself out." 

Scarcely any affection occasions greater distress to« 
the patient, and for that reason it is incumbent upon the- 
physician to study the subject carefully and attempt a cure. 
We believe that a careful reading of Dr. Salter's work will 
be of great interest to the physician and value to his pa- 
tients. The subject is thoroughly handled, and made in- 
teresting by the report of many cases. 

The Diseases of the Rectum. — Including Fistula, Hemorrhoids, Painful Ulcer, 
Stricture, Prolapsus, etc., with Diagnosis and Treatment. By WiLiiiAM: 
Allingham, M. D., F. R. C. S., Surgeon to St. Mark's Hospital for Fistula 
and other diseases of the Rectum, etc., etc. Fourth Revised and Enlarged 
Edition, with Illustrations. 8 vo., pp. 168; in paper 75 cts. ; cloth ■'B1.25_ 
Philadelphia: P. Blakiston, Son & Co. 1882. 

The author has long been known as excellent authority 
upon these forms of disease, and the fact of his work having 
attained a fourth edition, as well as being translated into- 
four of the continental languages, proves that his writings 
have been well received by the medical profession every- 
where. That portion of his book relating to surgical jDro- 
cedure is especially full and plain, and is of great value to- 
the occasional operator. 

Nitro-Glycerine as a Remedy for Angina Pectoris. By William Murrell, 
M. D., M. R. C. p. Lecturer on Materia Medica and Therapeutics at the 
Westminster Hospital, etc., etc. 12 to., cloth; pp. 78. Detroit: George S. 
Davis. 1882. 

The efficacy of this therapeutic agent in many cases of 
Angina Pectoris, not only palliative but often curative, can- 



248 The Peoria Medical Monthly. 

not now be questioned. This monograph of Dr. Murrell 
goes over the entire ground and tells about all that is known 
about it. His experience with this remedy has been exten- 
sive and lie reports failures as well as cures. The dose and 
method of administration of the remedy is given in detail. 
The make-up of the little volume is excellent. 

Essentials of Yafcinaf ion. — A Compilation of Facts Relating to Vaccine Innoc- 
ulation and its Tnfinence in tlie Spreail of Sniall-Pox. By W. A. Hakda- 
AVAY, M. D., 1'2 cloth; pp. 14(j. Price !?1.25. Chicago: Jansen, McClurg 
& Co. 1882. 

This volume gives an admirable resume of our present 
Ivuowdedge of this most important subject. The chapters 
upon ''revaccination," and " merits of different kinds of vac- 
cine viru.s," are worthy of the most careful study. '* The 
operation of vaccinating " receives a chapter, and the les- 
sons taught should be heeded by eveiyone. To properly 
perform vaccination is not as simple as it seems to be, and 
should not be relegated, as it often is, to the office student 
or druggist. The profession have not placed as much im- 
portance upon this operation as it should have, and the laity 
have come to consider it as trivial and to be done by au}'-- 
one who will do it the cheapest. The tendency of the work 
before us is to correct this erroneous impression and ad- 
vance vaccination where it belongs — one of the most im- 
portant operations we are called upon to make. 

We hope this book will have a large circulation, as it 
certainly deserves it. 

A Treatise on The Continued Fevers. Bj- James C. Wilson, M. D., Physician 
to the Philadelphia Hospital, and to the Hospital of the Jefferson Medical 
College, and Lecturer on Physical Diagnosis at the Jefferson Medical Col- 
lege, etc., etc., with an introduction by J. M. Da Costa, M. D., Professor of 
the Practice of Medicine, and Clinical Medicine, at the Jefierson Medical 
College, etc., etc. Cloth, 8 vo.; pp. 3(54. New York: Wm. Wood & Co. 1881. 

A Medical Formulary, based on the United States and British Pharmacopa;- 
ia.s, together with numerous French, German, and unofficial Preparations. 

By LArREXCE Jounson, A. M., M. D., Lecturer on Medical Botany, ^Medical 
Department of the University of the Citj" of Xew York, etc., etc. Cloth, 8 
vo., pp. 402. New York : Wm. Wood & Co. 1883. 

Traui^actions of the State Medical Society of Arkansas, at its Seventh 
Annual Session, held in Little Rock, MaySlst and June 1st, 1882. 
8 vo., paper; pp. 170. Kellogg Printing Company. 

Among the j^apers contained in this volume, worthy 
of especial note, we may mention, ''A Study of the Red 



Book Notices. 249 

Blood Corpuscles," b}^ Dr. T. E. Murrell; ''Insanity and 
Insane Asyliims/' by Dr. P. 0. Hooper, and " A Plea for 
Some Xegiected Branches in Medicine,'' by Dr. G. C. Hartt. 
The whole volume gives evidence of a first-class, live 
medical society, and is issued in excellent style. 

Paniplilets and Reprints. 

Tex Yeaes Experiexce ix the Teeatmext of Stric- 
ture OF THE Urethra by Electrolysis. By Robert 
Newman. M. D. Reprint from the Medical Record. 44 pp. 
paper. 

Stricture of the Rectum Treated by Electrolysis. 
Bj^ the same author. Reprinted from the New England 
Medical Monthly. 

The Relatioxs of Goitre to Pregxancy, axd De- 
raxgemexts of the Gexerative Orgaxs of Women. By 
E. W. Jenks, M. D. L. L. D. Reprinted from American 
Journal of Obstetrics and Diseases of Women and Children. 

Life of John M. Briggs, M. D., of Bowling Green, 
Ky. By W. K. Bowling, M. D. Reprinted from Nashville 
Journal of Medicine and Surgery. 

The Antiseptic Treatment of Wounds after Opera- 
tions AND Injuries. By W. T. Briggs, M. D. Read before 
the American Surgical Association, and reprinted from the 
Nashville Journal of Medicine and Surgery. 

Treatment of Fractures of the Skull, Recent and 
Chronic, with Depression. By Moses Gunn, M. D. Read 
before the American Surgical Association, and reprinted 
from the American Practitioner. 

An Old System and a New Science. By F. E. Stew- 
art, Ph. G. M. D. This paper will be mailed free of charge, 
upon application to the publisher. Geo. S. Davis, P. 0. box 
641, Detroit, Mich. 

The Columbus Medical College Imbroglio. By J. F. 
Baldwin, M. D. Supplement to the Columbus Medical 
Journal. 



250 The Peoria Medical Monthly. 



Hot Water in Surgical Practice. 

Dr. J. R. Weist read a paper on this suliject before the 
Indiana State Med. Soc, from which we abstract: — 

It is to the value of hot water as hemostatic agent, 
that I wish to direct chief attention, especially to its 
power, when the bleeding is from small vessels, or of the 
character denominated capillary oozing — a fact, I believe, 
first brought prominently before the profession by Dr. 
Emmet, in his Principles and Practice of Gynecology, and 
he gives Dr. Pitcher, of Detroit, credit for first calling his 
attention to the matter. He says that while operating, in 
1859, to close a vesico-vaginal fistula where free incisions 
were necessary, "the progress of the operation had been 
greatly delayed in consequence of oozing of blood."' This 
could be temporarily checked by pressure and ice, but in a 
few moments reaction would take place and the bleeding 
be as great as before. Dr. Pitcher being present, suggested 
a sponge probang be dipped into hot water and applied 
several times to the bleeding surface. This was done and 
the bleeding was promptly arrested. This led Dr. E. to 
the frequent use of vaginal injections of hot water in 
various uterine and" pelvic disorders associated with capil- 
lary congestion. Surgeons seem to have failed to appre- 
ciate the hint thus given, as no surgical work with which 
I am acquainted gives any prominence to the hemostatic 
j)roperties of hot water. 

In ovariotomy, after the separation of extensive adhe- 
sions, there is frequently a very annoying oozing of blood 
that must be arrested before closure of the abdominal 
cavity if septicemia and the subsequent death of the 
patient is to be prevented. In such cases the repeated 
application of sponges dipped in hot water will generally 
promptly arrest the bleeding, succeeding even cases in 
which the solution of the persulphate of iron has failed. 

In cases of hemorrhage, after removal of uterine 
fibroids, and for the arrest of hemorrhage following abor- 
tion, the injection of the hot water into the uterus suc- 
ceeds in cases wdiich would otherwise require the use of 
the tampon. 

Over the oozing from stumps after amputations, after 
removal of tumors, the superior maxillary bone, excision 
of the mammary gland, and various other operations, hot 
water has in my experience exercised a most important 
influence. 



Periscope. 251 

A very great advantage that hot water has over most 
other agents employed to arrest the kind of hemorrhage 
under consideration, is that it does not interfere with the 
subsequent healing process; it is possible that it promotes it. 

Cold water and ice, even, is much less efficient in 
checking hemorrhage than hot water. The immediate 
effect of cold is to contract the bleeding vessels, but this 
contraction is ver}^ soon followed by the opposite condition, 
dilatation: one that continues for a considerable period, 
and one that favors further hemorrhage. Besides, it is a 
fact well established that prolonged cold lowers the repara- 
tive power of tissues. 

The immediate effect of heat is to dilate the vessels, 
but afterward it contracts them. Dr. Pitcher s explanation 
of the manner in which hot water arrests hemorrhage is 
that the clot formed in the mouth of the dilated vessel, 
was held so firmly in position by the subsequent contrac- 
tion as to prevent its being readily dislodged. 

In hemorrhage from the nose, the injection of hot 
water has in my hands proved very effective, and I am per- 
suaded that in pulmonary hemorrhage the inhalation of 
hot water in the form of steam would prove to be a valu- 
able agent for its arrest. 

The value of hot water in hemorrhage and inflamma- 
tion depending on its power to contract the smaller blood 
vessels, and thus lessen the flow of blood to and the quan- 
tity in a part, involves some interesting physiological ques- 
tions. Capillary vessels possess no muscular elements and 
can be subject to no active change of caliber. The 
changes in diameter that do take place in them are pas- 
sive, and by virtue of their elasticity; and all the impor- 
tant changes therefore effected in a given part by hot 
water must be through vessels — arteries — larger than 
capillaries, whose walls contain muscular elements which 
are excited to action by nerve stimulation. This may 
probably be accomplished in two ways. Foster says (Text 
book of Physiology, p. 170), "The change in any given vas- 
cular area may be brought about by stimuli applied to the 
spot itself and acting either directly on the local mecha- 
nism (vasomotor) or indirectly by reflex action through 
the general vasomotor center." These physiological ques- 
tions, however, I am not competent to discuss, and I leave 
the subject with the remark that whatever may be the 
mechanism through which the effect is accomplished, it is 
certainly important to know that in hot water we have a 
simple, cheap and effective means for attaining important 
ends in surgical practice. — Amer Prac, July. 



252 The Peoria Medical Monthly. 

Pulsatilla in luflamatiou of the Testis. 

Although the use of Pulsatilla in the treatment of dis- 
ease has been chiefly contined to the homoeopaths, attention 
has been called to its etticaey. particuhirl^'in inflammatory 
aftections of the testis, by several members of the regular 
j)rofession. Dr. Piftard having especially commended it. 

A short time since, having a hospital service in which 
there were abundant opportunities to test its efficacy. I 
began its use in such cases. I had previously employed 
the ordinaiy methods of treatment, such as applications of 
ice, hot fomentations, tobacco poultices, etc.. thus having 
ample scope for the comparison of the results derived from 
the difl'erent procedures. The results of the remedy were 
very gratifying, and in most instances, whether given alone 
or in combination, superior to the ordinary" measures for 
relief of the aljove inflammations. The records of the cases 
so treated at that time I did not retain, but they contained 
a large numl^er of cases. I have l)een fortunate enough to 
have a series of five pronounced cases within the last few 
months, the history of which I have, and will recount, 
hoping that they may prove of interest. 

Case I. — Gouorihttcd epididj/niifis. — Patient is a pleth- 
oric suljject 9et. 35; stated that he contracted a severe gon- 
orrhoea some three weeks previously, which ran the usual 
course until two days before consultation, when the right 
testicle began to swell aud became very painful, the urethral 
discharge having ceased. He complained greatly of drag- 
ging pain along the cord. The epididymis of the aftected 
side was extremely swollen and of almost stony hardness, 
and the tunica vaginalis greatly distended; the tenderness 
on pressure was very marked. He was ordered a merca- 
rial cathartic, and tr. pulsatillse in 10 m. doses every two 
hours. The testes were supported upon oakum. On the 
following morning the pain had entirely ceased and the 
tenderness was perceptiblj" less. There was no change, 
however, in the bulk of the testicle, although the fluid in 
the tunica vaginalis seemed less transparent. At the end 
of twenty-four hours the Pulsatilla was stopped. There 
was no recurrence of the pain, and on the fourth day the 
tenderness was so far reduced that strapping was admis- 
sible, and was continued until the organ had regained its 
usual size 

Case H. — Bheumatic orchitis. — Patient a carpenter: set. 
24. Denied having had venereal disease of any description, 
and stated that he contracted his present trouble by sitting 
upon a cold stone step for some time, he having on thin 
pantaloons. The pain was especially severe, and was ac- 



i 



Periscope. 258 

companied by considerable nausea and fever. There was 
also some tenderness and swelling of the ankle joints. The 
bod}^ of the testis was swollen and tender; the epididymis 
somewhat enlarged, with slight elfusion into the tunica 
vaginalis. He was given a saline cathartic and put upon 
tr. Pulsatilla m. v. every hour. In twenty-four hours the 
pain, which had been so severe that I had thought seriously 
of subcutaneous incision of the testis, had considerably 
abated, and on the third day had disappeared, leaving, 
however, some tenderness and no appreciable change in 
the swelling. Hot fomentations and poultices were now 
ordered and continuously applied, until the induration had 
disappeared. 

Case HI. — Epididymitis from passage of sounds for re- 
lief of stricture and gleet, of long standing. — Patient, engineer; 
had had gleet for over a year, and had previously had a 
number of attacks of gonorrhoea. On the day following a 
somewhat prolonged instrumentation of the urethra, pain 
and great tenderness of the left testicle developed. The 
same treatment was adopted as in the preceding case, 
with, however, in addition, x minims of 11. ex. jaborandi, 
every hour, he having considerable fever and complaining- 
great ly of thirst. On the third day pain had entirely ceased 
and poultices were ordered. 

Case IV. — Gonorrhceal epididymitis. — History of pre- 
vious attack in same testicle, which laid the patient up for 
four weeks. The same line of treatment was adopted as in 
previous cases, and with marked success, the pain ceasing 
in twenty-four hours, and the gentleman being at his work 
again on the eighth day, the testicle, however, being strap- 
ped to produce resolution of the swelling and support the 
organ, thus preventing a relapse and enabling the patient 
to attend to his lousiness, which compelled him to be upon 
his feet a great deal of the time. 

Case V. — Somewhat similar to preceding case. Swell- 
ing and intense pain of neuralgic character in both the in- 
flamed and sound organs, this pain having severe exacer- 
bations shooting along spermatic chord and down the inner 
aspect of thighs. There was also considerable pain in the 
back. Fifteen minims of the tincture Pulsatillas were given 
every second hour, with the usual preliminary cathartic. 
In forty-eight hours the pain was markedly diminished, 
there being, however, some increase of the swelling. The 
remedy was stopped on the third day and poultices applied. 
There was a slight recurrence of the pain on the fifth day, 
which was again readily controlled, in a few hours, by the 
Pulsatilla. 



254 The Peoria Medical Monthly. 

From observation of the action of Pulsatilla upon the 
above cases and others, which, though carefully noted as 
to the effects of the remedy, were not recorded, I have been 
led Jo the conclusion that it is of great value. The drug 
has long borne the opprobrium of being a homoepathic 
preparation, and has been highly recommended by the 
small-pill fraternity; they, however, have administered it 
only in infinitesimal doses, in which it is o])viousl3^ impos- 
sible to obtain its physiological effects, so that it would be 
practicable to determine whether their so-called beneficial 
results were due to their small doses of the drug or were 
really the natural course of the affection, they never hav- 
ing applied rational measures of treatment, and being con- 
sequentl}^ devoid of data for comparison. They do not 
give any explanation of its action, but speak in a vague 
manner of its specific effect upon the mucous membranes, 
the female generative organs and the cerebro-spinal axis. 
It is probable that its effects are manifested principally 
through its influence upon the nervous system. It seems 
to have a specific action upon the testis itself, as evidenced 
by the speedy relief of pain and tenderness, although it has 
no effect upon the induration of the inflamed organ, and 
does not appreciably diminish the serous effusion attendant 
upon such cases. The beneficial effects of the drug in gon- 
orrhoeal epididymitis may possibly be due in some measure 
to its action upon the inflamed urethral tract, which con- 
stitutes the source of most of the cases of that disease. 

I cannot reconcile my observations to those of Dr. Pif- 
fard, who, in some of his earlier investigations of the sub- 
ject, found that flve minim doses of tr. Pulsatilla aggrava- 
ted epididymitis, while the same drug, in doses of one- 
tenth of a minim every three hours, rapidly cured the dis- 
ease. The doctor evidently has great faith in infinitesimals. 

I am not aware to what extent regular practitioners 
have investigated the action of Pulsatilla, nor to what ex- 
tent it has been written upon, but I trust that it may re- 
ceive a fair trial, and if it be found to be as valuable as I 
have been led to believe it, that it may enter more exten- 
sively into the pharmacopeias of legitimate physicians, 
thus rescuing a useful drug from the obscurity of homoe- 
pathic practice. — Chicago Med. Jour, and Exam'r. 



Aiiti-Listerism. 

Dr. R. Beverly Cole sums up an argument against Lis- 
terism in the following manner : 

1st. That whilst Listerism has, through the thorough 
cleanliness included in the system, lessened the mortality 



i 



Periscope. 255 

in German hospitals, it does not appear from their re- 
ported successes that carbolic acid has proved to be a 
germicide, or brought their percentage up to that of sur- 
geons who never employ it ; or, indeed, that it has exer- 
cised any agenc}' or influence whatsoever. 

2d. There is no proof, or even evidence, that the 
" germ theory " is a correct one ; certainly, so far as the 
micro-organisms of the atmosphere are concerned. 

3d. There is abundant evidence of the direct evil 
effects of the carbolic acid spray in abdominal surgery, 
particularly ovariotomy. 

4th. It must be admitted that an agent so irritating, 
and of such strength (as must be the solution of carbolic 
acid) as to offer the slightest hope that it may be germici- 
dal, so strong, indeed, as fairly to tan the integument of 
the operator's hand, cannot fail to be productive of great 
mischief to the delicate serous lining membrane of the 
abdomen. 

5th. The overwhelming evidence of such men as 
Keith, Lawson Tait, and even the author of the Listerian 
system himself, to the effect that it is unnecessary, indeed 
positively injurious in ovariotomy, producing kidney dis- 
ease and carbolic poisoning, etc., should at once and for- 
ever condemn the practice of its use in these cases, the 
more so since the most positive testimony (Dr. Keith) is to 
the effect that it does not prevent the mildest sejjticcemia. 

6th. There is not sufficient evidence, in the treat- 
ment of general operation wounds, of its superiority over 
other and older methods, outside of purification of the 
atmosphere of wards, and the general cleanliness observed 
in the local conduct of such cases, entitling it to any 
special confidence or consideration. 

7th. That in abdominal surgery the large preponder- 
ance of opinion is in favor of the observance of scrupu- 
lous cleanliness ; perfect arrest of all hemorrhage and 
oozing ; careful closing of the wound, so as to effect coap- 
tation of the serous surfaces ; and, in suspicious cases, 
where oozing is liable to recur, the employment of the 
drainage tube (glass), and the most careful avoidance of 
any needless disturbance of the patient or wound ; and 
last, though not least, the great importance of maintaining 
the normal temperature during the operation, which is 
impossible when the spray is employed, for the reason that 
the finely divided atoms have their capacity for heat in- 
creased and absorb it from the serous surfaces. 

8th. That in general surgery the weight of evidence 
tends rather in the same direction, although the whole 



256 The Peoria Medical Monthly. 

field has been covered from the open plan of Listen allow- 
ing plasma to glaze the surface, as a guarantee against 
oozing, to the immediate closing of the wound and employ- 
ment of drainage. There is, however, no general recogni- 
tion of the necessitj' of carbolic acid, or of its superiority 
over the iodoform cushion of Esmarch, the boracic acid, 
salycilic acid, chlorine water, decoction of eucalyptus, or 
even inire boiled water. 

This resume has been prepared with a view to placing 
the whole question concisely before the profession, under 
the conviction that it is as distinctly the duty of the loyal 
medical man to point out errors in practice as it is to pro- 
mulgate new theories, advance new opinions, or joresent 
new therajDeutic agents. 

"Ex vitio altei'ius sapiens emendat suum." 

— Western Lancet. 

Simulated Sciatica. 

In a clinical lecture on "sciatica," Mr. Jonathan 
Hutchinson {Med. Times and Gazette) says, "In nineteen 
cases out of twenty in which the diagnosis of 'sciatica' is 
suggested, there is no affection of the sciatic nerve w^hat- 
ever. They are simply cases of arthritic disease of the 
hip in one or other of its various forms — acute gout, 
chronic gout, rheumatic gout, subacute rheumatism, or 
chronic senile rheumatism. Both by the public and the 
profession these cases are constant!}' called 'sciatica.* 
Our workhouse infirmaries are full of chronic cases under 
that name, and I speak advisedl}^ when I say I feel sure 
that they are almost all examples of nwrhus coxce senilis. 
Of the cases of ' sciatica ' w^hich are not hip-joint rheuma- 
tism, some are probably affections of the fascia or perios- 
teum near to the hip : a minority are possibly affections of 
the sciatic nerve itself. In these latter it is the sheath of 
the nerve which becomes painful. The pain may be dart- 
ing, or may radiate, but it does not pass down the nerve 
^tubules or in any way make the patient conscious of their 
course. The diagnosis of true sciatica is to be based upon 
the discovery of tenderness restricted to the trunk of the 
nerve and involving a considerable part of its course. 
Examples of this are decidedly rare, and their recognition 
without risk of error is a matter of great ditficultv." — 
Med. Times, July 29. 

Nasal Catarrh. — Quinine. 

Dr. N. Falliott, writing to the British Medical Journal^ 
states that coryza or nasal catarrh may be cui'ed in a few 



Periscope. 257 

hours if taken at the onset, or at most twelve hours after- 
ward, by the inhahition of a spray of sulphate quinine. 
The solution used is made by dissolving four grains of 
quinine in an ounce of w^ater, with just enough of suffici- 
ently dilute sulphuric acid to dissolve it, and scenting with 
any agreeable perfume. The solution is injected up the 
nostrils in the form of spray with an ordinary hand-ball 
spray producer in such a way that the quinine can be 
tasted at the back of the mouth. This is done at every 
hour or oftener, according to the urgency of the symp- 
toms. He states that this remedy has been tried with suc- 
cess in hay fever, and that if nasal catarrh is of parasitic 
origin, as he strongly suspects, the action of quinine (as 
an antiseptic?) is at once apparent. It might be added 
that, even supposing catarrh to be the result of sudden 
change of temperature, the action of quinine in contract- 
ing the superficial capillaries would be quite as obvious. 
It is somewhat surprising that this property of quinine 
does not appear to have been tried for chilblains in the 
itching state, when the capillary vessels are dilated. — 
New Remedies. 



Purulent Conjunctivitis — Iodoform. 

Dr. Karl Grossman, Stanley Hospital, Liverpool {0]f)h- 
thalmic Revieic), considers iodoform to be of the greatest 
value in purulent conjunctivitis, both of simple and viru- 
lent nature. He makes use of a very fine powder, and 
dusts it upon the conjunctiva of the everted lids. He also 
advises its use as an antiseptic dressing in ophthalmic sur- 
gery. Its very slow and slight solubility makes it probable 
that a small quantity is sufficient for twenty-four hours,, 
and thus the bandage may be left on the operated eye for 
an equal period, or even longer. — N. Y. Med. Jour., July. 



iSoracic Acid for Granular Lids. 

Dr. James L. Minor says [Va. Med. Monthly) that he- 
has found boracic acid powder a most excellent applica- 
tion to granular lids. It is used as follows : The lids being 
thoroughly everted, the powder is spread freely over the 
whole conjunctival surface with a camel's hair brush. The 
acid is generously applied, and mixing with the discharge 
from the lids, it readily gains access to the cracks and 
crevices between the granulations, and thus comes into 
direct contact with the entire surface upon which it is in- 
tended to act. The immediate effect is to increase lachry- 
mation and to cause a burning, gritty sensation, with some 



258 The Peoria Medical Monthly. 

pain. These S3miptoms usually pass off within ten minutes, 
and are followed by an amelioration of all the symptoms 
wdiicli existed before the application of the acid. The 
granulations maj" look less gorged and prominent, but he 
has not been able to discover much change in the naked 
eye appearance of the conjunctiva after one application. 
The pow^der was used three times a w^eek. The improve- 
ment is so gradual that it is almost imperceptible as it 
progresses, but Dr. Minor has derived more satisfactory 
results from the use of this powder than from the ordinary 
caustic or astringent applications. — Med. and Surg. Bep. 



Differeutial Diagnosis of Abdominal Tumors. 

Dr. Erich, of Baltimore, contributes a very instructive 
paper to the Clinical Society of Maryland, Obstet. Gaz., 
wherein he points out how easily we may make very singu- 
lar errors of diagnosis in abdominal tumors. He illustrates 
his views by the narration of several cases, hoping, appar- 
ently, to add to the "known sources of error'' in arriving 
at a good diagnosis. In Case 1, a first examination per 
vaginam ''revealed an irregular, hard, nodular tumor in 
the left iliac region somewhat posteriorly,"' and a diagnosis 
of probable cancer was ventured. A year and a half after 
this examination the patient was examined jointly by Dr. 
Erich and Dr. Chadwick, of Boston, wdien the conditions 
noted had entirely changed. The tumor then noted had 
disappeared, " and a firm, round, movable tumor, about the 
size of an adult head, was found occupying the hypogastric 
region." Present diagnosis — a fibroid. It was decided to 
removed the supposed fibroid l^y laparotomy. Upon mak- 
ing an incision and bringing the tumor in view, an 
explorator}^ puncture was made which yielded pure pus. 
The patient died, and a post-mortem revealed an abscess. 
This case teaches that fluctuation can not always be made 
out, even when a large amount of fluid is present. " I was 
compelled to acknowledge an error of omission," says Dr. 
E,, " in not making an exploratory puncture before resort- 
ing to laparotomy, I have since then determined never to 
pronounce an abdominal tumor solid until after aspiration." 
Case 2 had been pronounced by an eminent surgeon a solid 
uterine fibroid. All the conditions so indicated ; but true 
to his determination, an aspirator needle was introduced 
by Dr. Erich, and to the surprise of himself, as well as 
others, " a pint of pure pus w^as withdrawn." In Case 3 the 
patient had been sent to Dr. E. by a friend who had made 
out " probable diagnosis of ovarian tumor." The examina- 



Periscope. 259 

tion made by Dr. Erich appeared to exclude pelvic cellulitis 
and abscess — the diagnosis of ovarian cyst was therefore 
Xn'ovisionally endorsed, and preparations for an operation 
were made. Preparatory to this a tonic treatment was set 
up, and a mercurial purge administered. The purgative 
produced diarrhoea with profuse and offensive discharges. 
Fever was established. The tumor was speedily reduced 
one-half. Aspiration, now instituted, removed a quantity 
of offensive pus and gas. The tumor was evidently a pel- 
vic abscess. In his concluding observations Dr. Erich re- 
marks : '" In view of these difficulties, which have been 
acknowledged by the best men in the profession as liable 
to occur to them, I think it advisable to use the aspirator 
in cases of doubtful abdominal tumor before pronouncing 
definitely upon its nature." — Canada Lancet, June. 



Post Partiiui Examination. 

Dr. Engleman, in the .S7. Louis Med. Jour., sums the 
treatment up in this manner : 

A. — Preventative Treatment After Induction of Lahor. 
1. Careful attention to everj^ detail, and strict observance 
of obstetric rules in every case of labor. 2. The adminis- 
tration of a full dose of ergot as the head enters the vagi- 
nal orifice. 3. Should hemorrhage threaten, follow the 
uterine fundus with the firmly superimposed hand. 4. Ex- 
press the placenta by Credo's method, and retain a firm 
grasp upon the fundus. 

B. — Treatment o/ Existing Hemorrhage. 1. External 
manipulation, pressure, and friction with the cold hand, or 
with ice. 2. Ergot- — best subcutaneously, while manipu- 
lations are in progress. 3, Introduction of the hand into 
the vagina, or uterus: removal of clots, and irritation of 
the surface, in order to stimulate contractions. 4. The 
subcutaneous administration of ether. 5. Ice or vinegar, 
if at hand, may now be tried in the uterine cavity, but if 
they fail must not be persisted in. 6. The hot water 
douche, which, if it is not followed by the desired contrac- 
tion, will at least stimulate the patient, and cleanse the 
cavity, so that the final, safest and most reliable remedy 
maj^ be resorted to, viz: 7. The iron swab — This may be 
used at once, if the introduction of the hand and the sub- 
cutaneous injection of ether fail or after a trial of the hot 
water douche; but in desperate cases must be resorted to 
at once, without losing time with other less reliable 
methods. 



260 The Peoria Medical Monthly. 

Definition of Misctirriag-e. 

The Brifidi Medical JouduiI says: "It should be 
clearly understood by all medical men that the term mis- 
carria^^e is a legal one, meaning the premature expulsion 
of the ovum or fetus at any period of gestation short of 
the full period of nine months." 

This piece of advice is called forth by the conduct of 
an English surgeon, who applied the word to labor at full 
term in answer to a question by the brother of a woman 
whom the surgeon had been called to attend, and who 
afterwards found himself implicated, at the Leeds Assize, 
in a case of unlawful concealment of birth. 

In admitting at the trial that he had used the word 
miscarriage carelessly and improperly, the surgeon showed 
so much hesitation that the judge threatened to commit 
him if he did not answer the question, and his costs were 
disallowed. In addition to the rebuke of the judge, the 
jury appended a rider to their verdict, in which they 
reflected upon the capacity of the surgeon. This act was 
regarded as a gratuitous insult by the English secular and 
medical press. 

We are unable, from the comment given in the journal 
from which we quote, to gather all the facts bearing upon 
it. but judge that the case was one in which the good name 
of the woman concerned was at stake; which being true 
the term of obscurity employed by the surgeon was justi- 
fiable in the eye of the higher law. 

Those laws which compel a medical man to appear, 
and upon pain of imprisonment force him to divulge in 
open court the secrets of which he necessarily becomes 
possessed through his professional relations to his patient, 
are a relic of barbarity, a disgrace to the Code, and should 
be erased from the statute-books of all enlightened nations. 
— Louisville Medical News. 



Choice of Drainage Tnbes. 

M. Niciase {Revue de Chirurgie) points out the impol'- 
tance of using non-irritant India-rubber drainage-tubes in 
the dressing of wounds. He gives the following directions: 

The tube should be short and wide, and should not be 
in contact either with the bone or ligature of the chief 
artery. 

Tubes are grey, black, or red. They should be made 
from laminae of pure caoutchouc cut with the saw, vulcan- 
ized, and desulphurized. Good tubes may be recognized 
by (1) the transverse markings left by the saw; (2) their 



Periscope. 261 

lightness; they should float on water; (3) their strength; 
they should bear being tripled in length without breaking. 
Bad tubes are made from sheets of paste made up with 
shreds of caoutchouc, zinc white, minium, etc. If grey 
they remain so after being dipped in an alkaline solution. 
Grey tubes have not been freed from sulphur, and this sep- 
arates and irritates the wound: they should be avoided. 
Red tubes which have been desulphurized by .soaking three 
hours in a hot ten per cent, solution of carbonate of soda 
may be safely used. Black tubes answering to the above 
tests are the best of all. — The Practitioner — Cin. Lan. and 
Clin. 



Gunsliot Wounds of the Vertebrae. 

These wounds are believed by the great majority, even 
of the well-informed profession, to be necessarily fatal. 
Such opinions have been so frequently expressed by physi- 
cians of prominence in medical and also secular periodi- 
cals, in connection with the Garfield case, that every 
paper teaching a different and a truer lesson is to be 
aopreciated. 

In the 32 cases given in the History of the Crimean 
War, 4 recovered. In 191 cases occuring in the French 
service, 13 recovered. In 187 cases reported by Confederate 
Surgeons, 7 recovered. In 149 Lumbar-vertebral cases 
reported in the "History of the Rebellion," 51 were dis- 
charged, and 28 returned to duty; a mortality not absolute, 
but of 45.5 per cent. In 16 reported cases of removal of 
the ball, only 5 died and 7 recovered. 

When such facts are considered, the report in the cure 
of this number becomes, in comparison, less astonishing, 
but the facts entire serve to increase the surprise which the 
unfortunate statements made in regard to Mr. Garfield's 
"inevitable deatlr' have so extensively and injuriously 
created. 

Gunshot wounds of the lumbar vertebrae are of course 
very serious, but when in 149 cases 79 have recovered, and 
when in 16 of operation 7 have recovered, the late teach- 
ings on this subject are very far indeed from the truth. 
They are not only unjust, but libellous to surgery. — Amer. 
Med. Weeklij. — Can. Lan., June. 



Treatment of Phthisis hy Inhalation. 

Dr. S. Dowse read a paper on this subject. He prefaced 
his paper by referring to the recent very valual^le discovery 
by Dr. Koch, concerning the tubercle-bacillus; and he 



262 The Peoria Medical Monthly. 

thought that the inflammatory theory of tubercle, and Dr. 
Sanderson's recent lectures at the College of Physicians 
on Inflammation, tended to support rather than detract 
from the results of Dr. Koch's original investigations. 

Dr. Dowse said that it was more than ten years ago 
when he first began to treat pulmonary consumption by 
inhalation; and he regretted that, until recently, he had 
not carried out his experiments with that care which so 
important a subject demanded. During the months of 
September, October, November and December, 1881, he had 
treated his patients in the North London Hospital for con- 
sumption, by several forms of inhalation, and he almost 
invariable had good results. He thought, however, that 
the process of inhalation was far from perfect, and he 
hoped for better results in the future. Short histories and 
notes of several cases were brought forward as evidence in 
favor of this mode of treatment. He spoke particularly 
ot the value of acetic ether as an inhalent; in fact, he 
went so far as to say this drug was, in his opinion, capable 
of dissolving nascent tubercle. The mixture w^hich he 
generally used had the following composition: 



Thymol, 


;5 drachms. 


^'Etheris acetici, 


8 drachms. 


^Etheris sulph., 


1 drachm. 


Creasoti, 


8 drachms. 


Acidi carbolici, 


15 minims. 


Terebine ad 


15 ounces. 



Ten drops to be used at a time for an inhalation. 

He laid great stress upon continuous inhalation: for 
instance, two hours in the morning, afternoon and evening, 
as well as during the whole night. The subject appeared 
to be of considerable interest. A lively discussion followed. 
— Brit. Med. Jour. — Can. Med. and Surg. Jour., July. 



Treatment of Cerebro-Spiiial Meiiing-itis. 

Prof. H. C. Wood, in a clinical lecture in the Medical 
Gazette, sums up as follows : During the first three or four 
days in the strong and robust, leeches or cups may be ap- 
plied to the temples or nape and upper part of the spine. 
Ice-bags are applied to the head and back of neck for the 
first days- — in many for a week. To relieve headache, rest- 
lessness and delirium bromide of potash is the best agent, 
gr. 20 to 30 every three hours. Its efficacy is increased by 
adding chloral (ten grain doses usually), or in those who 
cannot take chloral, tinct. hyoscyami (drachm doses). It is 
advantageous to add also tincture of castor (drachm doses) 
in the hysterically inclined. If possible don't use opium, 
but sometimes it becomes necessary, as the remedies al- 



Periscope. 26B 

ready named occasionally fail. The temperature is not 
apt to run over 104 degrees ( a very harmless height ) in 
adults except at the close, and quinine is not indicated ; 
moreover, it has no effect in lowering the temperature in 
this particular disease. The best way to lower tempera- 
ture, if this be an object, is by cold affusions, cold and tepid 
baths, or the cold pack. 



Mercury in 3Iembranous Dysnienorrlioea. 

Dr.Ormsby, of Xew York, gives five cases of painful 
menstruation, accompanied by the shedding of flakes of 
membrane, successfully treated with calomel in combina- 
tion with opium. His formula is as follows : 

;^ Ext. opii, gr. vj. 

Hydrarg. chlo. mit., gr. xij. 

Divide into twelve pills, one to be given every four 
hours till the gums are affected. He regards the known 
effiacy of mercury in all forms of hyperplasia, acute and 
chronic, as justifying a priori its exhibition in a complaint 
in which the hyperplastic element is recognized by pathol- 
ogists ; and his practice has completely confirmed this view. 
In each case when the mercurial treatment has been pushed 
so as to make the gums slightly tender, the next following 
menstruation has been painless, and the benefit so attained 
has been permanent without further medication. Painful 
menstruation is so much a question of habit, that to inter- 
rupt it for one monthly onh^ is almost to break it off alto- 
gether. Calomel has been the only salt of mercury tried, 
as it produces its effect rapidly and with little irritation. — 
New York Med. Bee. 



Opium Habit— Aveiia Sativa, or Commou Oats. 

Concentrated tincture of avena sativa has been 
strongly recommended by Dr. E. H. M. Sell, in a paper read 
before the State Medical Society of New York, and pub- 
lished in the Medieal Gazette, for the cure of the opium 
habit. This preparation is made by making an alcoholic 
tincture of common oats, distilling the alcohol off, and 
leaving an impure extract As different extracts require 
different re-agents for precipitation, the selection of those 
must be left to the judgment of the chemist. One ounce 
of the resulting precipitation must be dissolved in ten 
ounces of alcohol, and this forms the concentrated avena 
sativa. It is prepared by B. Keith k Co., 41 Liberty street, 
New York City. 



TXHE 



Peoria Medical Monthly. 



THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jefferson Street, .... PEORIA, ILL. 

*** A.11 exchanges, books for review, and communications must be addressed to the 

Editor and Puhllsiier. 

***Tlie publication day of this journal is on or about the lOtti of each month 

***To subscribers! A pencil mark at ill is place indicates lliat tlie time of your sub- 

scrlpiion has expired, and that a prompt renewal is urgently reques-ted. 

(gcUtoHal gepartm^ttt. 

Hints on Practice. 

I think it was Watson who said, in his introductory 
lecture to his students: "I cannot teach you the practice 
of medicine, I can only instruct you in the principles upon 
which good practice is founded." I was reminded of this 
the other day when called to see a patient who had been 
taking medicine from a druggist, for his malaria, without 
any good effects. The medicine prescribed was probably 
much the same as I should have given him had I seen him 
at first, but the giving of it would have been quite differ- 
ent. The medicine ought to have cured the patient had it 
been properly given. I have often met with my own pre- 
scriptions, that would not have the proper effect until I took 
them in hand and used them differently. There is as 
much in the giving of medicine as there is in the pre- 
scribing of it. This leads us to some thoughts on nursing. 
We all know how important this is. There is a proper 
time to feed a patient, almost as important as the kind of 
food they take. Nature often directs us in this. The 
appetite must be consulted, it is not best to disregard a 
longing for a certain kind of food, it may be just what the 
system requires. Rest is often better than medicine, sleep 
restores the nervous system, and in that way reduces the 
temperature in fevers. This we often observe in typhoid 
fever, the temperature is from one to two degrees lower in 



Editorial Depaetment. 265 

the morning than evening. Patients should not be dis- 
turbed too often by inquiring about their condition. The 
frequent visits of friends often retard the cure, thus con- 
stantly reminding the patient that he is sick, I have seen 
patients commence to convalesce after a tedious illness, by 
the attending physician saying to them, " you are better, 
you may not feel it yourself, but you are better this morn- 
ing." It has acted as a stimulant when nothing else 
v^ould. 



The Qiiincy Scliool of Medicine. 

The medical college epidemic, which has been raging 
in many neighboring states for several years past, has at 
length invaded Illinois, and this fall has witnessed the birth 
of two brand new medical colleges in our state. Chicago 
was the first to succumb, and now Quincy follows close 
after. Poor Quincy ! So near to St. Louis, Joplin and Keo- 
kuk, how will the Quincy school be able to compete with 
these great medical centers ? Tacked on to the tail of an 
obscure university, placed on a par with a business college, 
a telegraph institute, a law school, a literary school and 
probably a theological seminar3^ we fear it will be swamped 
by its associaties. Still, we will give the new school of 
medicine some points, and believe that if followed, there 
may yet be some hopes for Quincy. 

In the first place, they should claim more than 35,000 
inhabitants, which everybody knows is not enough for a 
medical center. If necessary we will lend them the names 
of at least 40,000 Peoria people, which, added to the 60,000 
of Adams County, will make at least a fair sized city for a 
medical college. 

Again, they should include as professors the names of 
every practitioner in Adams County; then get each profes- 
sor to contribute, say $2,000, as a building fund. This 
might not pay the professors, but it would at least put up 
a fine building. 

Again, being in close proximity to Keokuk, they should 
reduce their fees to a competing price of ten dollars or so. 
Competition is the life of trade in medical colleges as well 



266 The Peoria Medical Monthly. 

as in all other branches of business, and low fees always 
succeed in filling up the benches. 

Again, they should guarantee that the Adams County 
IDOor house shall furnish a sufficiency of dissecting ma- 
terial, so that students will not have to grub for themselves, 
w^hich is sometimes dangerous business, and results in re- 
ducing the number of students. 

Again, they should not have stopped at permitting 
'' four years of well attested reputable practice to be taken 
as one course of lectures, at the option of the faculty," 
but should permit eight years of well attested, etc., prac- 
tice to be taken for two courses of lectures. This would 
make the college exceedingly popular with the ten-year 
men of the Illinois Medical Practice Act. 

Again, they should not copy the famous '" Joplin " an- 
nouncement so closely in size, color of cover, make up, etc., 

etc.. as it may lead to confusion. 

^ -^ ^ ■^ ^ ^ ^ 

In all earnestness, and with all kindly feeling for the 
members of the faculty, for some of whom w^e have great 
regard, we think the establishment of this medical college 
a great mistake, and one which the medical profession will 
regard with no great amount of favor. 

We believe that no city of less than 100,000 inhabitants 
can furnish sufficient clinical material to justify the ground- 
ing of a medical school. 

The profession does not need more colleges, but better 
ones ; the people do not demand more doctors, but better 
ones ; and, with the present number of established medical 
schools in this countiy, unless a new college can offer su- 
perior advantages over those alreadj^ in operation, there is 
no reason to justify its foundation. 

With the clause above rt^ferred to, that of permitting 
four years practice to pass as a course of lectures, w^e be- 
lieve the diplomas of the Quincy school of medicine w^ill 
not and should not be accepted by the Illinois Board of 
Health. 

We predict for the new^ college a scanty success, disap- 
IDointing to its projectors and regretted by all who have at 
heart the higher education of medical practitioners. 



Editorial Department. 267 

All Ajiology. 

For the first time in tlie history of tlie Monthly an 
apology is really due to its readers. The October issue is 
considerably behind time, and our only excuse is that ''we" 
were moving. The pleasures of moving have doubtless 
been experienced by very many of our readers, and to them 
we appeal without apology. If you do not get your 
Monthly just on time this month, be easy w'ith us, kind 
friend, and we promise it shall not happen so again, at 
least for a like reason. While we are at it we might as 
well apologize for several errors that crept into the Sep- 
tember number; for these blame the x^rinter, and blame 
him all you please, yea, "cuss" him if it will do you any 
good. Our mind is now relieved. 



Award of Prizes. 

Our readers will remember that some months ago 
Allaire, Woodward & Co. offered a series of prizes for the 
best essays on the Examination of Powdered Drugs. We 
herewith append the report of the committee by whom 
the essays were examined : 

We, the committee appointed to award the Allaire^ 
Woodward & Co. prizes for the best essay on the Examina- 
tion of Commercial Powdered Drugs in the American mar- 
ket, respectfully report, after a careful comparison of the 
papers submitted, that the essay on Powdered Rhubarb^ 
numbered 35, is, in our opinion, entitled to the first prize — 
a Beck microscope worth $100. We recommend as deserv- 
ing of second prize (a $60 microscope), the paper on Pow- 
dered Ipecac, numbered 43 ; and the third prize ( a $40 
microscope), to the author of the paper on Powdered Jalap^ 
numbered 8. 

We also recommend, as deserving of honorable men- 
tion, the papers on Powdered Opium, and Powdered Ex- 
tract of Licorice, numbered, respectively, 32 and 38. 

It seems proper to state, in justice both to the authors 
of essays to whom no prizes w^ere aw^arded and to the 
members of the committee, that owing to the high order 
of merit of nearly all the papers submitted, considerable 
difficulty was experienced in placing the award. The mat- 
ter was made more complicated by the fact that a consider- 
able number of different subjects were treated. 



268 The Peoria Medical Monthly. 

We desire in conclusion to express our gratification 
that the offer of Messrs. Allaire, Woodward & Co. has been 
successful in adding so much information of a reliable 
character to the sum of knowledge on this important 
sul)ject. 

[ Signed, ] Wm. Saunders, 

J. U. Lloyd, 
Ernest B. Stuart. 
In explanation of the above it is proper for us to state 
that the essays refei-red to by the committee in their report 
Avere written by the following gentlemen, whom we con- 
gratulate upon their success : 

No. 35— Mr. Geo. W. Hayes. Philadelphia. 
No. 43— Mr. Theo. H. Wurmb. St. Louis. 
No. S— Mr. Virgil Coblentz, Springfield, Ohio. 
No. 32— Mr. Geo. D. Hays, New York City. 
No. 38— Mr. V. E. Phillips, Olney, 111. 
Very respectfully, 

Allaire, Woodward & Co. 



Notes and Comments. 

Dr. I. J. Bennett has removed his household goods and 
gods from Norwalk, Wis., to Jefferson, Wis. 

The Minnesota College Hospital began its second course 
of lectures Oct. 2, with over fifty matriculants. 

Dr. W. R. Nash has returned to Fairmount, 111., from 
Crawfordsville, Ind. We wonder whether Hoosier malaria 
got away with him. 

The College of Physicians and Surgeons, Chicago, 
opened its first course of lectures with over one hundred 
students in attendance. We wonder how much the forty 
dollar fee had to do with this ? 

The Illinois State Pharmaceutical Association was in 
session at Chicago last week, Mr. F. C. Bourscheidt, of 
Peoria, presiding. A full attendance was had and a profit- 
able meeting to those present. 

A successful case of transfusion of blood after post- 
partum hemorrhage, has lately been reported by Dr. Walter 
in the British Medical Journal ; also one by Dr. A. J. Stone 
of St. Paul, Minn., for repeated hemorrhages during typhoid 
fever. 



Editorial Department. 269 

Dr. Willard Y. Piersol of Hermon, Knox County, 111.^ 
was married on September 7 to Miss Sidney V. Martin of 
the same place. The congratulations of the Monthly go 
out heartily to our good friend Dr. W. and his bride. 

We have received the second edition of Dr. Cathell's 
excellent work, "The Physician Himself." It must be 
most gratifying to Dr. C. that a second edition has been 
called for in so short a time, and we notice that he appre- 
ciates it too, for he has thoroughly revised his work, adding 
an index and many pages of new matter. 

Another card upon our desk notifies us (and our read- 
ers) that Dr. Albert S. Core, the talented oculist of Quincy, 
111., was married on October 11 to Miss Julia T. Trude of 
Grand Ridge, La Salle County, 111. Some good things do 
really happen to Quincy once in a while. Shake, Brother 
Core, shake heartily, and when you attend the State Medi- 
cal Society meeting in Peoria next May, bring Mrs. Core 
with you. 

The story is told of a noted Philadelphia laryngolo- 
gist, who on examining a girl with relaxed uvula and 
mucous membrane of the throat, concluded that the cause 
of the difficulty was some uterine trouble, and for which 
he advised her to place herself under the care of her fam- 
ily physician. Her reply was: "Dr., if I had known that 
you could see all the way down, I should not have come to 
you." — Mich. Med. News. 

One of the most important papers read before the late 
meeting of the American Pharmaceutical Association was 
that of Mr. C. B. Allaire of this city, on Adulterations 
in Powdered Drugs. The facts presented are startling. 
He thinks that all extract of licorice is adulterated. Nine 
out of eleven pale cinchonas were found to be adulterated. 
Thirty-eight out of forty-five specimens of ipecac were im- 
pure ; eighteen out of forty-four of rhubarb. In many cases 
powders are made out of the whole root, when only the 
bark of the root should be used. The papers gave rise to 
considerable discussion, and should be printed in full for 
the benefit of everyone, especially physicians. 



270 The Peoria Medical Monthly. 

Receipts. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
]preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card : 

Illinois— Drs. S. C. Balch, M. L. Brown, J. H. Farrell, C. Trues- 
dale. J. T. Taylor (2 years), F. J. Patera, W. H. Day, J. J. Reaburn, F. 
N. Cumiin,2;liam, C. True, J. W. Coyner, T. H. Bras (2 years). 

Missouri — Drs. Fred. B. Schulz, W. L. Weems, J. R. Yates, Ira 
T. Brouson, A. V. Banes. 

Kansas— Drs. E. G. Whetstine, W. McMullen, W. G. Conner, R. 
H. Arrington, Jay H. Payne, S. W. Taylor, Wm. Tanner, J. Z. Scott. 

Arkansas — Dr. Thomas J. Pollard. 

Iowa— Drs. E. D. Frear, M. B. Cochran, D. O'Doherty, W. S. Pitts, 
G. N. Skinner, F. T. Searles. 

Kentucky — Drs. Wm. A. Graham, Thomas C. McCarty, D. W. 
Porter, W. Whambuth, B. F. Dixon. 

Wisconsin — Drs. Fisk & Mailer, I. J. Bennett. 

Nevada — Dr. Joseph A. Stites. 

Texas — Dr. A. Garwood. 



Some Thing^s That May Interest You. 

St. Louis, Mo. After many years' experience with Kennedy's Ex- 
tract of the Pinus Canadensis, I unhesitatingly state that its use in all 
diseases affecting the mucous membrane is invaluable. 

James C. Nidelet, M. D., 618 Olive St. 

Louisville, Ky. I have used Celerina in the treatment of nerv- 
ous diseases with tlie most grntifying results, and in a few cases of opium 
habit. I am thoroughly satisfied with its remedial effects in this particu- 
lar affliction. Very respectfully, W. T. Leachman, jM. D., 

Office, 303 W. Walnut St. 

Our readers will doubtless notice the new advertisement of the New 
York Pharmacal Association in this number. We do not believe that 
anything more can be said in favor of that most excellent preparation, 
Lactopeptine, than has already been repeatedly said by the whole med- 
ical profession of the country. It has become a standard remedy and 
we could not get along without it. 

Beef Peptonoids is a new candidate for favors, and we predict a 
rapid and gratifying success. We are now trying it in a couple of cases, 
and will at some future time give results attained — be they good or bad. 



The Peoria 
MEDICAL MONTHLY. 



Vol. hi. NOVEMBER, 1882. No. 7. 



©^-igittal (S;ammunirnti0u^. 



Aet. I. — Dental Plagiarism, or Amalgam Poisioning. Its Origin and History. 

—By J. Payne, D. D. S., Dwiglit, 111. Continued from October Number. 

A strange lady in a distant city sent her thanks to me 
for saving her life. She had been for years in a similar 
condition to the young lady in St. Louis, but immediately 
began to recover on having the plugs taken out. As soon 
as the publication appeared in the Democrat, persons under 
every degree of this form of poisioning, from mere slight 
headache to the last stages of what had been pronounced 
tubercular consumption, came to consult me. One lady 
came in and said, ''Now I know what has been the matter 
with me all these long years, and now I know what killed 
my sister." A certain lawj^er called on me and wanted the 
amalgam taken out. He had always been accustomed to 
performing in the gymnasium, but after his teeth were 
filled, he found his flesh and strength gradually forsaking 
him until he was greatl}^ reduced and wholly too weak and 
too short of breath to engage in anj^ such exercise. A 
young man, a printer on the St. Louis Repuhlican, was 
barely able to walk and had entirely lost his voice and had 
to speak in a whisper. He had formerly lived in Brooklyn, 
N. Y., and the doctors could do nothing for him, but ad- 
vised him to move west with a hope that a change of cli- 



272 The Peoria Medical Monthly. 

mate might benefit liim, and he came to St. Louis. A well- 
known physician in the latter city told him that he had 
better prepare for death, that he had tubercular consump- 
tion and could not live. When I informed the Professor of 
Chemistry of the discovery I had made it turned out that 
he had a daughter that had gradually gone into a decline 
and for two years she was unable to attend school, and al- 
though every thing was done that he himself and the ablest 
medical skill of the city could devise she continued to 
grow worse, but now attention was directed to the teeth 
when it came to light that she too had amalgam in her 
teeth, and being taken out, like all the others, she recov- 
ered. This case was also published. 

The amalgam being very hard and difficult to get out 
of the teeth, and having such a rush of that particular kind 
of business I found it necessary to devise some more expe- 
ditious method of removing the plugs than was then known, 
and work that had required hours to perform could, by 
the new method, be done in nearly the same number of 
minutes by softening the plugs. This was published in the 
St. Louis Dental Journal, of which I was editor, and was 
copied by leading Dental journals of the Ignited States and 
Canada. 

But while all these things were transpiring another 
matter was being inaugurated. As soon as the publication 
came out in the Democrat, war commenced. A certain 
clique of dentists met and commenced their vile abuse 
and slanders, and passed resolutions denouncing me as a 
mountebank, and entered into the blackest conspiracies to 
ruin my business and in one way and another have kept 
up their war ever since. 

Leaving St. Louis for the present, I wish to allude 
briefly to some similar cases of poisoning that I had in this 
village, and in view of their magnitude, at the instance of 
a prominent physician of this place, I wrote a letter to the 
President of the Illinois State ]\Iedical Association, then in 
session at Bloomington, giving an account of this poisoning, 
and requested that body to appoint a committee to visit 
Dwight, and I would show them a number of cases that 
would place the matter beyond controversy. The conven- 



Original Communications. 273 

tion was about to adjourn when my letter was received and 
it was too late for such action to be taken. The President 
of the convention, however, sent my letter to the Chicago 
Medical Journal and had it published, and it was subse- 
quently copied into the Dental Cosmos, of Philadelphia. 

Several parties replied to my letter and tried to hold 
me up to ridicule, and declared that no such poisoning as I 
had described could possibly take place, and proposed to 
have a committee appointed to have me hung or sent to a 
lunatic asylum. Then a professor in Harvard University, 
conducted a series of experiments lasting through three 
months, for the purpose of testing my theory, and after- 
w^ards, at a special meeting of a dental society held in the 
city of New York, the most eminent dentists of all the 
eastei'n cities being there assembled, the Professor laid be- 
fore the meeting the manner in which he had conducted 
his experiments and the results that followed, and it was 
shown to the entire satisfaction of all present that the ex- 
periments of the Harvard professor had demonstrated that 
there was absolutely no e/ rounds for the theory I had ad- 
vanced. It was set forth in a circular letter that the meet- 
ing would be made up of dentists of such well-known abil- 
ity that the bare mention of their names would be all the 
guarantee necessary of the excellence of whatever they 
might present. And this vast body of gentlemen of un- 
questionable wisdom and learning, with a Harvard profes- 
sor as the central figure, declared by their unanimous vote 
that corrosive sublimate could not be made as I had des- 
cribed, and that there was no foundation to my theory and 
that amalgam plugs could do no possible harm. And then 
a vote of thanks was unanimously/ given to the Professor as 
a reward for the valuable contribution to science in the 
experiments which were shown to have cost so much money 
and arduous labors and which would result in great bless- 
ings to the human race. And finally a full account of the 
experiments and the proceedings of the meeting were pub- 
lished in pamphlet form and distributed broadcast through- 
out the civilized world. 

For reasons that will appear hereafter, it will be proper 
here to state that this Harvard professor is a practicing 



274 The Peoria Medical Monthly. 

dentist in high circles, being the head of a dental firm hav- 
ing an office in the city of New York and another one in 
Paris, France. He is also a member of learned societies 
both in America and Europe. I particularly request the 
reader to bear these facts in mind. In addition to being 
published in the dental and medical journals and in the 
newspapers, I had five thousand circulars distributed 
through this section of Illinois giving a brief account of 
this amalgam poisoning, and notwithstanding the violent 
opposition that I encountered, a great many people have 
seen these publications and after long years of suffering 
have been restored to health by having the amalgam re- 
moved. Only a short time ago, a lady who had been declin- 
ing for several years, until she had become a complete 
wreck, and the doctors were wholly unable to diagnose her 
case, saw one of these publications which so accurately des- 
cribed her condition that she went to a dentist and had the 
amalgam removed, and without taking any medicine she 
entirely recovered. This statement was made to me by 
the lady herself. In another instance a lady sent one of 
my circulars to a friend in another State who, she said, was 
in exactly the condition described in the circular and that 
her friend had had some teeth plugged with a material that 
the dentist rubbed up in the palm of his hand, and that 
previously to that time the health was good but began to 
fail soon afterwards. In this way these publications have 
become widespread and the people themselves are finding 
out what is destroying them and the dentists are every- 
where forced to admit the facts. It will thus be seen that 
the light has not been kept under a bushel. 

Now, at this late day, and in the face of all the fore- 
going publicity, a man comes before a dental association 
and pretends that he has been experimenting and has just 
made the discovery that amalgam is poisonous. 

When the Chicago Medical Journal published the re- 
plies to my letter written to the State Medical Association 
I immediately prepared a full and complete reply to the 
parties and that reply I read to a certain dentist in Chi- 
cago, and left the manuscript to be published in the Chicago 
Medical Journal. After it had been there three weeks and 



Original Communications 275 

finding that the editor did not intend to publish it, 1 wrote 
to him requesting its return, which was done. I next tried 
to get a newspaper to insert it in its columns, but there 
were such a vast army of dentists advertising in the paper 
that that channel was also closed against me. And now 
my enemies had the field and they construed my silence 
into an inability to reply to them and were jubilant. I was 
then advised to publish my reply in book form and bring it 
before the people, that being the proper place where every- 
body could see it. Acting on this advice I rewrote and 
enlarged it and was thus enal)led to enter more fully into 
the details of the great variety of ways that people are 
ruined by these plugs than could be done in a short paper. 
Having completed it in this form and being absent the next 
day, my ofiice was burnt and my book went up in smoke. 

It was during these trials that the Harvard professor 
was, unbeknown to me, engaged in his experiments to show 
how vain were all my labors, in which, it afterwards trans- 
pired, he spent three months of his precious time besides 
a large sum of money. In course of time I got my work 
ready for the printer the third time, and this, according to 
the general understanding among mortals, ought to have 
been the "(?/^«r;;^" but through the Harvard professor I 
was again doomed to disappointment, for just as I had 
finished writing I received the awful pamphlet above al- 
luded to by which I found myself completely annihilated 
and all my labor of writing my book three times was 
shown to be a total loss. 

This was the hardest blow of all. With all this bril- 
liant display of master spirits, such an assemblage of giant 
intellects, arrayed against me, and so well known through- 
out the country that the bare mention of their names 
would immediately put a quietus on any ordinary mortals 
who would dare venture an opinion in opposition to what- 
ever they might decree, and having given such wide-spread 
publicity to my ignorance, was to me a greater calamity 
than the burning of my manuscript, for, mind you, it was 
not the ignorant, itinerant part of the dental profession 
that were assembled. There were no privates in the ranks 
on that occasion, but the meeting was composed entirely 



276 The Peoria Medical Monthly. 

of Major Generals. They were the very head and front, 
the leaders, who occupy high places in life, members of 
learned societies at home and abroad, and professors in 
great universities. This was the class of men wdio con- 
fronted me. They were the leaders and all the rest fol- 
lowed. And then I found myself single-handed and entirely 
alone, assailed by the entire dental profession, for as soon 
as the opposition was inaugurated not a man could be found 
who would enlist on my side. Several of my friends com- 
plained of me for condescending to notice certain parties 
to whom I had replied and said they were unworthy of my 
attention and I regretted myself that I didn't have higyer 
game, and now neither myself nor my friends could find 
any room for complaint, for certainly these distinguished 
leaders were " worthy of my steel," and adopting for my 
motto, " Come one, come all " " And damn'd be he who first 
cries, hold, enough," I again prepared my defense. 

Once more getting my work completed it was this time 
actually placed in the hands of the printer. This publish- 
ing house was owned by a bank in Chicago, and after 
printing some fifty pages the bank " busted " and with it 
away went the publishing house and again my book was in 
trouble. I then tried two other publishing houses, but 
now the country was plunged into the panic occasioned by 
the Resumption Act and both said they had no money and 
advised me to let it rest till business revived. Since that 
time I have been engaged in other matters which made it 
impossible for me to give it that attention which it would 
require, and so the matter rests. 

In the mean time other parties seeing that a great 
many cases of the kind of poisoning I had described were 
coming to light, imagined they saw an opportunity to win 
laurels for themselves and have thus attempted to wrest 
from me the credit of bringing this question before the 
public, but when my book is published and all the facts 
are known, they shall be welcome to all the fame that 
awaits them. 

There are a great many kinds of stealing in this world^ 
of every degree from that of stealing a chicken to stealing 
a railroad, but the meanest of all thefts goes under the 



Original Communications 277 

euphonious name of plagiarism. This applies to the edu- 
cated class of thieves who have more education than brains^ 
and not having a sufficient stock of intellect to originate 
ideas of their own they lie in wait for others to work out 
difficult problems, and then appropriate these hard earn- 
ings of others to themselves. They aie literary pirates^ 
jparasHes, that live off of others. In the case under consid- 
eration, the pilfering was all the meaner because the thief 
lacked the courage to show himself in the foreground in 
the early part of the struggle but waited till the battle was 
won and then stepped to the front. During the time this 
warfare has been going on the trade in amalgam has been 
rapidly increasing until it has reached a magnitude beyond 
conception. Another point worthy of consideration is the 
fact that one kind of amalgam is now made and put in the 
teeth that is actually composed of nothing but copper and 
mercuri/, both deadly poisons. 

I must not conclude this communication without a brief 
notice of poisoning from rubber plates. When the rubber 
first began to be used as a base for artificial teeth, the Rub- 
ber Company of New York wanted me to act as their agent 
for the introduction and sale of this material in the West. 
Finding that the compound was colored with vermilion, a 
preparation of mercury, I wrote to the company that it would 
poison the people, but in this as in the amalgam I was met 
with opposition. In Harris' Principles and Practice of Den- 
tistry, he ridicules the idea of vermilion being poisonous 
calls it '' inert vermilion," and speaks of numerous experi- 
ments that he and others have made to prove that it is en- 
tirely harmless. This author says that the rubber plate 
cannot be acted on by any thing taken into the mouth. 

Notwithstanding this high authority, which is regarded 
everywhere as standard, I have shown in my book that his 
statements are not entitled to the least credit, and I have 
shown that the vermillion in a rubber plate, instead of be- 
ing the harmless "inert vermilion," as he calls it, that it is 
now ruining thousands of people and is the cause of a long 
list of fatal maladies, among which I have no hesitation of 
naming cancer and consumption, the late theory of Pasteur, 



278 The Peoria Medical Monthly. 

that consumption is caused by a parasite to the contrary 
notwithstanding. 

Allusion has been made to a prominent dentist in Chi- 
cago to whom I read my reply to the parties in the Chicago 
Medical Journal. In addition to that, I read to him, at his 
request, a good deal in my book on poisoning from rubber 
plates. We had been long acquainted and were on friendly 
terms. We had frequent interviews, and he asked me many 
questions in regard to the manner of poisoning from amal- 
gam and also from rubber plates. He was using the cellu- 
loid base at that time and he was greatly surprised when I 
told him that that was also poisonous, being likewise colored 
with vermilion. After obtaining from me all the points he 
possibly could remember, he went to a meeting of a dental 
association held at Ann Arbor, Michigan, and made a speech 
on poisoning from rubber plates and forgot to say where he 
obtained his knowledge, but led his professional brethren 
to believe that the ideas he there advocated were the result 
of his own brain and hard study, and for which he was 
loudly applauded, and he actually had the cheek to tell me 
this himself. It has always been customary in the medical 
profession that when a man advances a theory or makes a 
discovery, to give him credit for it, no matter how trivial it 
may appear. In anatomy, if a man discover a cavity in a 
bone or a slight protuberance on a bone, or any little thing 
in any part of the human body that has not been seen be- 
fore, either in the hard or soft parts, or in the fluids, as mi- 
nute specks floating in the blood, such discovery takes the 
name of the man making it. For instance, a cavity in the 
cheek bone that was so very conspicuous that it would seem 
impossible for any anatomist to overlook it, and probably a 
dozen might have seen it, all about the' same time, still the 
first who pointed it out was a Doctor Highmore, and it has 
ever since borne his name. Antrum Hi(jhmorianuni. 

And so it is in dentistry. About forty years ago Dr. Hu- 
lihen, a dentist in Wheeling, Va., drilled a little hole in the 
neck of an ulcerated tooth hoping to let out the matter that 
collected at the end of the fang instead of letting it escape 
by forming a gum boil opposite the point of the fang, and 
although it disappointed the expectations of its author it 



Original Communications 279 

has borne his name ever since. The same principle holds 
good in agriculture and horticulture, and in fact in every 
department of life. In the small fruit department we have 
the Kirtland red raspberry, brought out by Professor Jared 
P. Kirtland, of the Cleveland Medical College ; and the Tur- 
ner red raspberry named for Professor J. B. Turner, of Jack- 
sonville, III, who first produced it. These little honors are 
awarded to the parties as marks of respect and for the en- 
couragement of scientific advancement. The party I com- 
plain of has not only attempted to appropriate my ideas 
but has in several instances used my own language and 
suggestions, such as the " vapor of mercury escaping from 
the plugs," the material "used by the ton/' and the sugges- 
tion made to the medical practionerto "examine the teeth 
for amalgam," the very language used in my reply that was 
left in Chicago and which I read to my friend (?) in that 
city. 

The foregoing is a straightforward statement of facts, 
which can be fully sustained by an abundance of evidence, 
and in conclusion I ask you as a matter of simple justice to 
allow my statement to occupy a place in your columns, and 
at the same time, by affording discussion of this question, 
it will aid in opening the eyes of the people as to the cause 
of numerous strange maladies for which, in vain, they seek 
relief in remedial measures, changes of climate and visits 
to the springs. 



Art. II.— What is Vital Force and What Relation Does it Hold to Death and 
Disease? By G. W. Caepender, M. D., South Bend, Ind. 

Physiologists have thus far been able to give only a 
limited exposition of vital force, and in that exposition have 
generally supposed it to be modified electricity. But what 
electricity is has thus far been beyond their research. The 
nearest they have come to it is to produce a manifestation 
of something the call a fluid or principle, they don't know 
which. Its velocity and quantity can be quite accurately 
measured, and therefore it is electricity. They have deter- 
mined that two kinds exist, but the specific quantity and 
proper use has thus far proved too much for the experi- 
mentalist, especially as a therseputic agent. 



280 The Peoria Medical Monthly. 

I wish in this paper to try and open up a new vein o^ 
thought for some superior mind to enlarge upon. Has it 
never struck your mind, dear reader, that the word elec- 
tricitj^ might posibly be a misnomer ? We have two words 
that are often used indiscriminately when speaking on the 
subject, viz, magnetism and electricity. True there is a 
distinction, but where to draw the lines, that is the ques- 
tion. It does not exactly do to say correlation of force, for 
the reason in the electro magnet, for instance, the magnetic 
force is arrested only by the change in polarity of the in- 
duction coils, and the thing called electricity is only felt by 
the interruption of the flow of the current (if current it be). 
The thing or principle known as electricity would continue 
to flow in its current, and evidently would be the same and 
only w^ould be known as magnetism if it was not inter- 
rupted by a change of prolarity. Then let me ask what 
l^ecular change it undergoes per se, when we know it as elec- 
tricity ? I would answer none. It is the same in arrest or 
non-arrest. If it is magnetism in the magnet while con- 
tinuous, it is magnetism when broken in its current, and 
its difference is not of correlation but of mode of motion. 

Is it a current at all ? In constructing a battery, we 
are careful to so arrange the elements that the fluid may 
jDass from one element to the other by passing opposite di- 
rections, expecting that the proximate parts will give a 
common center for equalization. 

Having generated the thing called electricity, what 
becomes of it ? Does it re-unite with the elements, or does 
it pass off" into the atmosphere ? It will continue to be pro- 
duced as long as the elements are in a given condition. 
Then again there are two currents, the advance and return ; 
and if the induction coil be added there will be four cur- 
rents as a result of the first elements, and if we go on ad- 
ding coil to coil we only multiply currents. But what 
becomes of them, as to obtain any knowledge of them we 
must connect by conductors to the two ends of the coils, or 
battery, and in the coils we cannot find any change of char- 
acter to suit the phenomena, neither loss nor gain in quan- 
tity or quality ? In the battery proper we find change. But 
in the electro magnet none. What is it then ? From the 



Original Commtjnicaticns 281 

air, you say. Well, then, if it is in the air is it a new com- 
position of air particles or is it from decomposition of air 
that it is produced ? If decomposition what element is set 
free ? Why, correlation of force, you say. Very well, if 
force has only returned to force where it has l^een made 
manifest by resistance or interruption, does it immediately 
return to the atmosphere ? If so by what means, as during 
the action it has simply been conducted from one pole of 
the battery to the other, and interrupted only to make it 
appreciable to the senses. That it does not accumulate we 
feel certain, as there is neither waste of material nor .aath- 
ering in store of the fluid. There are very many questions 
which the present theories would incite to but which sci- 
ence, so-called, would fail signally to answer, and which if 
answered at all must be by another theory of what it is. In 
the old electric machine we could collect and hold in reserve 
the electric fluid and discharge it at pleasure exactly in 
similitude to the lightning's flash from the charged to the 
-uncharged cloud ; and that fact only renders the question 
more important and ]3y right the easier to answer. 

All of nature's phenomena are easily understood if the 
key can once 1)e obtained to her library of knowledge. She 
has it all written out and every experiment is on record, 
preserved either in her laboratory or museum. The diffi- 
culty with man is he keeps lookin-g for mystery. Nature's 
laws are simple and few, and imperative. To reach her 
conclusions we must be accurate, which in our haste and 
ignorance we are not apt to be. But to answer our ques- 
tion we must approximate to nature, and to do this we will 
let nature present herself as our answer. 

All organisms are but the com])ination of aggregated 
atoms holding different relations to each other. Taking 
the human body as a system, if the science of chemistry 
is trustworth}^, it is composed of at most not more 
than sixty-five different elements, and the most of them 
in very minute quantity, while the larger share is 
simply water or two elements combined, the balance 
are elements in combination with water or held in 
solution, bearing in mind the ultimate particled conditions 
of these elements. As the foundation of all combinations, 



282 The Peoria Medical Monthly. 

comiDounds or organizations what do we find? Simply the 
atom, which is quantity and quality. The quality is that 
part of the atom which appropriates or discards, attracts 
or repels, loves or hates. We call it magnetism. It is 
that which gives polarity, and by it gives motion or rest. 
It is one of the dual properties of all atoms. No atom 
can exist without it. This is what we mean by automagne- 
tism. Atoms may be arranged into two classes, and science 
has been able to distinguish them by the name of mineral 
and vegetable. In the electrical positive and negative. 
Among organized beings male and female. In the gasses 
oxygen and hydrogen. In temperature cold and heat. The 
casuist will recognize them in mind and matter. 
Besides these there is nothing, unless there be a spirit es- 
sence pervading all things, which is God per se. But with 
him we have nothing to do in this argument. It is with 
matter as we find it, with its endowments of' vital force. 

There is a tendency to aggregation in all matter by 
virtue of its magnetism, each atom appropriating to itself 
all likes within the radius of its attractive force, simply by 
the law of change of polarity, when united becoming the 
stronger magnet. This union is simply intermarriage and 
must be by opposite magnetism. As there are only two 
classes, but a variety in each class, the unions must be at- 
tained by variations and result in crystals and organisms, 
interruptions occur and virtually are manifest, when 
in organism's interruptions occur and vitality is manifest. 
When there is no interruption in the magnetic flow crys- 
tals are formed, each assuming form according to quality 
and polarized conditions of its primates. By multiplying 
the conditions the variety of formatives and formations re- 
sult. Aggregate, compound and combine and all organized 
beings have their existence. 

Now let lis apply these postulates to the query, vitality 
is only automaguetism. The properties of the blood are 
only the properties of the body in solution. The phe- 
nomena of heat is only a result of magnetic attraction 
and when the elements are furnished in suitable quantity 
and quality there would be only heat sufficient elminated to 
hold in solution, till a proper distribution could be had of 



Original Conmunications 283 

the necessary elements for exchange. It requires all the 
elements found in each organization to produce the heat 
necessary to the genus, and every genus has its type, and 
its possibilities lie only in the fulfilment of the type. Add 
to or take from any one ingrediant and you destroy the har- 
mony of the being, and by the laws of its inherent affinity 
it will either be aroused to repel or depressed to the level 
of the agressor. Fever, then, is a physiological result of 
the changed demands, either to repel or exhaust, the too 
rapid molecular changes of auto-appropriation. In 
either case the functional labors are beyond the elected 
ability of the organization, especiallj^n localities, and has- 
ten the necessities of repair beyond the combined ability of 
the organism, and results in disease. If the element in ex- 
cess cannot be interrupted in its magnetic force, combina- 
tions will take place so rapidly that a rise in heat will be 
sufficient to incite to fermentation, when there will be a 
disintegration of tissue, either to supply a new diathesis or 
the formation of new organism, and sometimes both, as is 
seen in examthematous diseases. 

One principle more I will refer to and then close this 
already too lengthy article. I refer to that principle of in- 
herent longevity. Each type of being has a type of vital 
force inherent to its combining arrangement of ultimate 
particles and qualitative primates. The magnet if left 
without use sufficiently long will lose its combining or ap- 
appropriating property, or the aggregate force becomes 
subject to the law of inertia or latenc}', and must be again 
excited to motion. If left alone it will perish with age. So 
with vital function. The magnet must have the excite- 
ment of change in polarity to manifest its power, and all 
motion ultimates in change of molecular arrangement 
equal to waste and withdrawal from the sphere of attrac- 
tion, and is w^hat we call old age, hence all organisms must 
of necessity cease at some time to be in combining dis- 
tance of atomatic attractions. Heat cannot be kept up ; 
the power of solubility of atoms lost, and a concentration 
of force will be had at local points, with the symptoms of 
a senile ferment and decay, or a general lack of supply of 



284 The Peoria Mecical Monthly. 

material will cease ; a too low state of heat and what we 
call congestive chill will supervene. As a result of with- 
drawal of atoms from the sphere of the magnetic influence 
vital force cannot be kept up, and what we call death is 
the result of vito-chemical action. 



A New Index Rerum for Students and Profeesional Men. Published by Joel 'A 
Miner, Ann Arbor, Michigan. Price, full size, $3.25; half size, $1.75. 

The Index Rerum can be made the most valuable book 
in a physician's library ; it will take a little time and 
trouble, but when the habit is once formed of using it, this 
will be found very slight indeed. 

" A large portion of the advancement in medical knowl- 
edge first appears in medical journals, where it is quickly 
lost sight of unless it is preserved by some selective refer- 
ence. The busy physician has less time to ransack his 
library for some important though half-remembered fact, 
than members of other professions. His science requires 
so many exceptions to fixed procedures that he will fail of 
the largest success, unless he brings to his aid the recorded 
experiences of the entire profession." 

Many physicians say they cannot take more than two 
or three journals and get any good out of them, but if they 
used a book of this kind and formed the habit of noting in 
it, titles of articles, remedies, diseases, operations, etc., with 
a concise preference, they could take and profit by a dozen 
or more journals. 

We advise especially the young physician to get in the 
habit of using a book of this kind, and feel certain that he 
will never regret the trouble. 

The Physician's Visiting LLst for 1 883. Published by P. Blakiston, Son & Co., 
Philadelphia, Pa. 

This most popular visiting list published has reached 
its thirty-second year, and is still being improved. Among 
the additions to its usefulness we note a concise chapter on 
the Metric system by Oscar Oldberg, Ph. D., of New York. 
This book will be bought by all who have used it before, 



Book Notices. 285 

and by all who may see it now for the first time. We be- 
lieve it has the largest sale of any similar publication, 

On Slight Ailments. Their Nature and Treatment. By Lionel F. Beale, 
M. B. F. R. S., Professor of the Principles and Practice of Medicine in King's 
College, London, etc., etc. Second Edition, Enlarged and Illustrated. P. 
Blakiston, Son & Co., Philadelphia, Pa.: 1882; cloth; pp. 280. Price $1.25; 
paper 75 cts. 

An old physician once said to the w^riter, " It is the 
little things that will gain for you the most credit." And 
such we have found to be the case. The only trouble was 
to find any work that would tell us about the "little things." 
Ponderous tomes are filled with the most exasperatingly 
minute inquiries into the nature of the rarest diseases, but 
the little things are left for the young doctor to work out 
as best he may. The student may think such things be- 
neath his dignity, but after a year or two of practice he 
will turn to this work, or a similar one if it may be found, as 
his best friend. 

The introductoiy chapter is excellent and eminently 
practical. 

Then follow chapters on " The Tongue in Health and 
in Slight Ailments." "Appetite, Nausea, Thirst, Hunger." 
'•Indigestion." "Constipation and its Treatment." 
"Diarrhoea." " Intestinal Worms." "Vertigo, Griddiness." 
"Biliousness, Sick Headache." "Neuralgia, Rheumatism." 
" On the Feverish and Inflammatory State." " Of the Actual 
Changes in Fever and Inflammation," and lastly " Common 
Forms of Slight Inflammation." The book is well indexed 
and well gotten up. We predict that its former popularity 
will be greatly increased. 

Rheumatism, Gout, and Some Allied Disorders. By Morris Longstreth, M. D. 
Attending Physician to the Pennsylvania Hospital, etc. 8 vo., cloth, pp. 
280. Wm. Wood & Co., 56 and 58 Lafayette Place, New York. 1882. 

Of this work 221 pages are devoted to Acute Rheuma- 
tism; 18 pages to Chronic Articular Rheumatism; 10 pages 
to Gonorrhoeal Rheumatism and 26 pages to Gout. We do 
not discover that the author introduces any thing new on 
the subject, and we are of the opinion that he ommitted 
some new things which have proved to possess value in the 
treatment of these disorders. The work gives one the im 
pression of being a compilation rather than an original 



286 The Peoria Medical Monthly. 

treatise, and in some places is crude and un grammatical. 
In the chapter on Gonorrhoeal Rheumatism we find the 
statement that, second attacks are less common than those 
of ordinary rheumatism, which is the reverse of our experi- 
ence and what we have been taught on the subject. No 
reference is made to mercury in this form of the disease, or 
the use of quinise, both of which have given us the most 
gratifying results, and which are highly recommended by 
good authority, {ride, International System of Surgery, Vol. 
II, page 2S9). Xo mention is made of the return of the 
urethral discharge after the subsidence of the articular 
symptom, these and many other omissions which might be 
given have led us to form the opinion above expressed. 

In general terms, however, we may commend the book 
as being the latest on the subject, pleasing in style and ar- 
rangement and one which will be welcomed by every sub- 
scriber to Wood's Library for 1SS2, of which it forms the 
October volume. 

The Pliysicians 3Iemoraii(lnm Book. Fifth improred edition. Arranged and 
published by Joel A. Miner, Ann Arbor, Mich. Price .$1.2."). 

This new visiting list has all the general advantages of 
books of its class. Its tables of printed matter are as ser- 
viceable as in any similar book; its size is that preferred 
by most ijhysicians; and its variety of blanks covers all 
that is usually required in such books. 

It has, besides, special claims to superiority in i\iQ gene- 
ral convenience of its hlanks, its Ledger sheets, its Clinical 
Record, and its Cash Accounts. 



getiisroiJ^. 



Tlie Curability of Epithelial Cancer and Kindred Ulcers. 

In attempting to write anything upon this subject I do so 
quite fully realizing the difliculty and embarrassment sur- 
rounding it. I am aware of the immense work that has 
been done and the numberless and radically diverse views 
concerning the pathology, classification and treatment of 
such ; and concerning all these — except treatment — I shall 
attempt nothing ; but, on the other hand, simpl}^ confine 
myself to a statement of the clinical facts concerning these 
ulcers just as they have observed in my own practice, feel- 



Periscope. 287 

ing that the results I here record are of sufficient value to 
invite unprejudiced investigation. 

I am also aware that many admitting the results will 
be ready to place the treatments and consequent recov- 
ery in the relation of coincidence merel}^ and in no way 
bearing the relation of cause of effect. 

The diversity of classification, nomenclature and pa- 
thologic relations of these lesions as held by the better part 
of our profession is my reason for calling all my cases car- 
cinomatous. 

Gross (vol. 1., pp. 260) defines rodent ulcer, lupus, can- 
croid and other similar aftections to be carcinomatous — 
essentially, and he defines that class of lesions to be " ma- 
lignant and having tlie effect of destroying not only the 
tissues in which they are located, but also the life of the 
patient," and he should have added, that by any means at 
present generally known, incurable, he would have im- 
Xoroved the description. 

I will give simply the physical symptoms, history, treat- 
ment and results of each of my cases. Every one of the 
cases here described were treated extensively by one or 
more good practitioners, and some of acknowledged abilit}^ 
and the diagnosis as it came to me from my predecessors 
was in every case '"cancer.'' 

I was led into this partieular treatment by the condi- 
tion of case No. 1, which would not permit the use of the 
knife in any way and no form of caustic, and the certainty 
with which death would follow if the ulceration was not 
arrested. 

I will not attempt to give the therapeutic reasoning 
by which I was induced to use the ergot in the first place, 
but I will say in the first place that I found that all wiiters 
on this subject held that these ulcers progressed by reason 
of their excessive cell growth or hypernutrition and know- 
ing almost if not every remedy had failed of the cure I could 
think of nothing— as an effort— more suited to the indica- 
tions, that of diminishing vitality, vascularity, and capillary 
circulation, and at the same time as free from ol)jection, 
than ergot. 

I tried it in the first case and the manifest result was 
astounding to the patient, other physicians who had treated 
him and myself, and was as incredibly unexpected as ac- 
ceptable. To the incredulous I will say that the exact cor- 
rectness of this report is attested by every medical man 
who saw the case. 

Case I. W. W., ^t. 67. Applied to me in April, 1876, 
for the treatment of an ulcer of the left side of the neck 



288 The Peoria Medical Monthly. 

and face, involving the parotid gland and ear ; which ulcer 
was about four or live inches in diameter, extending from 
the meatus of the ear downward and forward along the 
sterno cleido mastoid muscle, the center being below the 
angle ot the low^er jaw% and w^as of an irregular circular 
shape and surrounded by an elevated, indurated and nodu- 
lated margin or roll about one inch in diameter, thus mak- 
ing the extreme extent of the ulcer about six inches. The 
general depth being about one inch below surface of mar- 
gin, yet in the center it was deeper, at which point the pul- 
sation of the carotid artery w^as plainly visible. The floor 
was covered with indurated, nodulated bodies and the dis- 
charge was of a sanious nature, the elevated margin and 
the floor being quite hard. The cervical, post-cervical and 
sub-maxillary lymphatic ganglia were much involved, being 
indurated and tender. He was emaciated, weak, had poor 
appetite, and colliquative sw^eats, and the color of his face, 
which in health had been very florid, was very pale and the 
exact appearance of the cancerous cachexia in advanced 
cases. The ulcer commenced in a hardened elevated tu- 
mor of the skin just below the point of the ear, growing 
slowly, not painful at first ; when, about two years pre- 
vious, it had attained the size of a walnut, the ulceration 
of the surface of the tumor began and pain also set in The 
ulceration of the ulcer steadily progressed until it attained 
the size described, and latterly had frequent profuse hem- 
orrhages, until at the time I saw him death seemed immi- 
nent from exhaustion of the carotid vessels. The situation 
and depth of the ulcer precluded the use of the knife or 
cautery, and all of the physicians whom he had consulted 
having told him that his death would shortly occur, at his 
urgent request I undertook to try something and my inves- 
tigation led me to try ergot for the reasons stated. 

The fresh ergot was fresJdij ground to an impalpable 
powder and applied three times daily to the entire face of 
the ulcer with a large soft hair-pencil, the ulcer being 
w^ashed thoroughly once every day. The powder was used 
dry, allowing all to adhere that would. After each appli- 
cation the ulcer was covered with a light muslin rag w^et 
with a lotion of 

Ij Carbolic acid, 1 drachm. 

Sulphurous acid, 4 drachms. 

Glycerine, 1 ounce. 

Aqua, 2% ounce. 
M. Sig. Lotion. 

He was also put upon quinine, iron, codliver oil and 
the other usual adjuncts to a restorative treatment. In a 
short time the discharge assumed the appearance of lauda- 



Periscope. 289 

ble pus, the induration of the lymphatic ganglia disap- 
peared, the elevated, stony and nodulated periphery subsi- 
ded, the floor assumed a healthy aspect and in twelve weeks 
the ulcer had entirely healed and has remained so up to 
the present time. His general health rapidly improved 
and up to this time has been continuouslj^good. This gen- 
tleman had an uncle to die of a similar ulcer and an aunt 
of cancer of the breast. All of the physicians who treated 
this case previous to myself were and are confirmed that 
it was ei)ithelial cancer. 

Case II. Mrs. E. K., aet. 40, married, no children. This 
case was sent me from an adjoining county in March, 1S77, 
by her family physician, with the statement that she was 
buffering from cancer of the left breast of about three years 
since it began. I found the body of the gland entirely de- 
stroyed and its site occupied by an excavated ulcer about 
five inches in diameter and an average depth of about one 
inch. Margin elevated, indurated and nodulated. The ul- 
ceration was in active progression, her general S3'stem 
much depressed, loss of appetite, colliquative sweat, etc. 
The lymphatic ganglia of the left axilla were enlarged, ten- 
der and indurated, in fact were so coalescent with the mar- 
gin of the ulcer that I could discern no line of separation. 
The super clavicular glands of the left side were extensive, 
indurated and enlarged. This case began as the preceding 
— by a small scaly movable tumor of the skin near the 
nipple. Her famil}" history showed no case of cancer. The 
treatment of this case was precisely the same as case Xo. 1, 
yet the recovery was not so rapid and it was not until Au- 
gust following that the ulcer was covered hj a cicatrix, 
and not until December that all induration and tenderness 
had disappeared, and up to this date it has shown no sign 
of recurrence. Her general health has also remained good. 

Case III. Andrew B., aged 70. Applied to me in Oc- 
tober, 1877, with an ulcer of the outer angle of the left 
orbit, about two inches in diameter, with an elevated, in- 
durated and nodulated margin. The ulcer being sunken, 
the floor being covered with tuberculated elevations, the 
discharge slight and sanious, and the ulcer painful. It was 
of about twenty months, standing and commenced with a 
scaly tubercle of the skin, w^hich ulcerated about a year 
before I saw it. This case had been treated by two excel- 
lent physicians before I saw it, both of whom pronounced 
it epithelial carcinoma. This case was treated by the ap- 
plication of the dry powdered ergot three timers daily, wash- 
ing it once daily and at all times keeping it free from any 
crust or scab. This ulcer healed nicely in two months and 
has shown no sign of return. 



290 The Peoria Medical Monehly. 

Case IV. Thomas H., get. 55. Applied to me in March, 
1879, with what his physicians had tokl him was cancer of 
the lip of one year standing, I found him suffering from 
a fungoid ulcer of the mucous margin of right side of lower 
lip, very painful and bleeding frequently. I removed the 
fungous mass by scissors and applied the ergot as in the 
preceding cases, which soon produced an excavated ulcer 
about three-fourths of an inch in diamater, and under the 
continued use of the ergot the ulcer filled up by granula- 
tions leaving but a slight scar. This patient had an older 
brother to die from an ulcer of the lip exactly similar to 
his own as far as it proceeded. 

Case V. M. D. B., a^t. 75. Came under my treatment 
in 1875 with an ulcer of the nose of ten years standing. He 
had been treated by a number of physicians, but with little 
benefit. In 1877 I commenced applying the ergot and suc- 
ceeded in arresting the ulcer in the locality ulcerated, yet 
it would ulcerate in new places until 1881 when it died. 

Case VI. J. CI. C, set, 45. Applied to me in March, ISSO, 
with an excavated ulcer, one inch in diameter, of the right 
upper eyelid, of eighteen months standing, which had been 
treated by three reputable physicians, all of whom pro- 
nounced it cancer. His mother died of scirrhus of the 
breast. The application of ergot was used and in six w^eeks 
the ulcer was healed and there has been no return. 

Case VII. John S., get. 65. Applied July, 1880, with 
carcinomatous ulcer of right side of cheek, near the nose, 
of two years duration. Tlie case was very similar to Case 
VII. The ulcer being somewhat larger. The ergot was used 
and perfect healing resulted in two months and no return 
to date. 

Case VIII. George D., ret. 48. Applied January, 1882. 
Ulcer of left side of the nose, one inch in diameter, twentj^ 
months duration. Healing resulted in five wxeks under 
same treatment. 

Case IX. Joseph H. L., at. 70. Applied March, 1882. 
Ulcer of tip of the nose, of three years duration, one and 
one-half inches in diameter. Treatment as before and re- 
covery in four weeks and no return. 

Case X. John S. W.. a^t. 60. Applied September, 1880. 
Ulcer of left cheek, two inches in diameter, excavated with 
raised edges, of two years duration, and very painful. 
Treatment as before and recovery in four weeks and no re- 
turn. 

I have tried the ergot in two other cases of carcinoma, 
but both were of the deep-seated scirrhus form, one of the 



Periscope, 291 

fauces, the other of the mammary gland, but the effect, if 
any, was not perceptible. 

In this article I have given the facts just as they oc- 
curred and leave it to others to judge of them, at any rate 
I have great confidence in the ergot and shall at present 
continue its use in similar cases, not caring or asking 
whether they are rodent, lupus or carcinoma. — Dr. Collins 
in Lancet and Clink-. 



A'iburmiin Priinifolium. 

In the August number of the Gazette I noticed a com- 
munication from Dr. W. S. Clilmore upon the dangers of 
the indiscriminate use of this drug, and having had a simihir 
experience I deem it to be in the line of duty to record it. 
Xext to ergot I place more dependence upon viburnm in 
the treatment of diseases of females than any other agent 
for internal administration. Its action is not limited to the 
prevention of miscarriage b}' any means, but it is alike ap- 
IDlicable in cases of uterine engorgement, ovarian irritation 
and the numerous conditions of the female sexual organs. 
Before reading Dr. Gilmore's article I had noticed in three 
or four cases that my patients had slight dimness of vision, 
impediment to speech, dizziness, drjmess of the mouth and 
throat, and at times an unsteady gait, towards the end of 
my treatment of the cases, when the patients were nearly 
or quite well of their uterine troubles. I attiibuted them 
to general weakness, or, at least, some cause other than the 
use of viburnum; hence I gave these symptoms less atten- 
tion than I otherwise would, the patient recovering prompt- 
ly from them. I now know the}" recovered upon my dis- 
continuing the viburnum, a fact that then escaped my 
notice, as the medicine was discontinued at or near the 
time of the patients' recovery from their uterine disease. 
But at the time I read the doctor s article in the Gazette I 
was sorely perplexed to account for certain sj'mptoms in 
a young lady patient then under treatment. The case 
was that of a lady twenty-six years old, unmarried, and a 
school teacher by occupation. She had been sent to me by 
Dr. McXabb, of Xewargo, this state, to be treated for re- 
troversion of the uterus: it was an aggravated case, the 
patient having been bed-ridden, for two jxars, and suffering 
Avith all the neuroses usually found in such cases. There 
was tenderness along the spine, ovarian neuraliga. pain in 
the top of the head, with excessive trembling upon the 
slightest excitement. These tremblings would be brought 
on by a person speaking to her suddenly, or by a stranger 
entering the room, shutting of a door, etc. ; this symptom 



292 The Peoria Medical Monthly. 

was so bad at first that I found it almost impossible to 
make a vaginal inspection. I commenced treatment by 
replacing the uterus and holding it in position for the first 
three days with cotton tampons saturated with glycerine; 
these I changed every day and at the time ot changing 
gave her gallon injections of hot. water at 100 degrees F. 
to reduce the cervicitis; after this time I adjusted a " soft 
rubber and silver wire pessary which held the uterus in 
place nicely, but continuedthehot injections while the pes- 
sary was still in situ. In addition to this I gave internally 
fl. ex. black haw and ergot equal quantities, a teaspoonful 
each in four hours; also, bromide of ammonium in ten gr. 
doses three times a day. This medication was continued 
uninterruptedly for three weeks when she had almost en- 
tirely recovered from her nervous troubles and was able to 
walk three or four blocks, besides riding for an hour each 
day (pretty good results considering she was brought to 
the city on a lied). At about this time she commenced to 
complain of a dizzy feeling in the head, dryness of the 
mouth and throat, spells of dilficult breathing, pain in the 
eye-balls, and an inability to complete her sentences; when 
speaking her voice was indistinct, and she would stop in 
the middle of a sentence and then commence upon another 
subject entirely foreign to the one she was talking about. 
To this was added an unsteady gait quite similar to locomo- 
tor aiaxij, for when she arose from a chair it was with the 
head thrown partly backwards and the eyes fixed upon the 
wall opposite; in this position she would slowly rise to her 
feet and walk off unsteadily with the head in the same at- 
titude as when rising. Twice she tell down while walking, 
but did not entirely lose consciousness. She expressed her 
feelings by saying her legs gave out and she was going to 
fall. I began to think that perhaps I had made a mistake 
in diagnosis, and that her nervous troubles did not depend 
entirely upon her uterine disease, but perhaps upon organic 
disease of the spinal cord and brain instead. When I read 
Dr. Gilmore's article the similarity of the symptoms de- 
tailed by him and those of my patient led me to suspect 
that the black haw might have something to do with the 
condition of this patient, and I determined to leave it off. 
I did so but continued the bromide of ammonium, and in 
two days, to my great surprise, everyone of the unpleasant 
symptoms had vanished, and the patient continued un- 
interruptedly to recover, being able at the end of ten days 
to leave the city for her home. She has steadily improved 
and now enjoys her former good health. A case as striking 
as this in connection with the others preceeding it, and 



Periscope. 293 

those reported by Dr. Clilmore has quite naturally, I think, 
led me to believe that viburnum has other i^roperties than 
those ascribed to it; and while it is an excellent remedy for 
the diseases above mentioned, it is by no means harmless 
or devoid of danger, but, on the contrary, is capable of 
producing dangerous results, and should be given with cir- 
cumspection, discontinuing it upon the first symptoms of 
dryness in the mouth and throat. The bad results obtained 
by Dr. Clilmore came on much sooner than in my case, his 
patient complained of the dizziness, and the dryness in the 
throat upon the second day, but that is doubtless accounted 
for by the fact that she took it every hour in one-half to 
three-fourth teaspoonful doses, while my patient only took 
it once in four hours and then only in one-half teaspoonful 
doses. My other cases, however, were atfected sooner I be- 
lieve, though I cannot tell now just how they had taken 
the drug. I shall in the future carefully watch its action, 
and I think others will do w^ell to do so. — Dr. E. 0. Herrick 
in Obstetric Gazette. 



A Xew Metliod of Treating Uterine Hemorrliag e 

Physicians of experience know the extreme difficulty, 
sometimes, of arresting uterine hemorrhage, the uterus 
seeming to defy all remedies, and pouring forth the san- 
.guineous fluid in spite of astringents, ergot, the tampon, 
etc., etc. The danger of uterine injections often causes 
physicians to hesitate long before resorting to them. I 
have been frequently placed in this dilemma, and although 
I have used injections successfully, yet I must admit that 
I always felt relieved when I found that the injection had 
not produced any dangerous consequences. 

In view of the foregoing considerations I concluded to 
take a departure from the usual methods, as will be seen 
in the report of the following cases : — 

Case 1. — During the latter part of October, 18S1, I was 
called to see Mrs. H.. who was suffering from severe uterine 
hemorrhage. I treated her with the ordinary remedies, 
but without producing any permanent benefit. The tam- 
pon, applied again and again, would, of course, produce 
temporary suspension of the flux, but upon its removal the 
hemorrhage would return as badly as ever. The constitu- 
tional effects resulting from the loss of so much blood be- 
coming alarming, I concluded something must be done. 

At my next visit I took my uterine applicator and 
placed upon it a spiral slide, leaving about three inches of 
the point uncovered. The point I wrapper! with absorbent 
cotton in the same manner as for endometritis, with the 



294 The Peoria Medical Monthly. 

exception that the end next the slide I made considerably 
thicker than the rest, and tied a thread around it, so as to 
withdraw the cotton when its purpose was accomplished. 
I then dipped the cotton into glycerine, and dusted it ef- 
fectually with powered persulphate of iron. I then ex- 
posed the OS with a speculum, and passed my loaded ap- 
plicator into the uterine cavity, and with the slide pushed 
off the cotton and left it. From that time my occupation 
in this case was gone. She made a rapid recovery. 

Case 2.— March 30, 1SS2, was called to see Mrs. W., 
who had been suffering with uterine hemorrhage for two 
months. I was of the opinion that she had had an abor- 
tion. Init she denied it. She had l:)een under the care of 
another physician, who had treated her with the usual rem- 
edies, the principal one being ergot. Her clothing and 
bed showed very plainly the severity of the hemorrhage. 
I also found several clots in the vagina. I used the persul- 
phate in the same way as in Case No. 1. When leaving 
I requested her to let me know in a few days how she got 
along. In about a week I received a note from her saying 
that the hemorrhage ceased from the time of the applica- 
tion, and that there had been no return. I have met her 
several times since, and she was quite w^ell. 

Case 3.— Mrs. R. aborted about May 1, 1SS2. I saw 
her June 29th. The attending ph3^sician had gone through- 
the usual routine of remedies, adjninistered internally, ap- 
parently without any benefit. Ilmmediately made an ap- 
plication of the persulphate of iron after the same manner 
as described in the former cases, and the result was an 
immediate arrest of the hemorrhage. She was in my of- 
fice to-day, and as I had this article partly written, I asked 
her the particulars of her case. She said she had " wasted " 
for eight weeks, and that she had taken ergot nearly all 
of that time ; and also that there was scarcely any dis- 
charge perceptible after I introduced the tent, and that 
there had been none since, beyond her periods. 

It seeuis to me that this is a much more rational method 
of treating uterine hemorrhage than by either internal 
remedies or by injections. That it is much safer than by 
injections no one can deny, and I would not hesitate now 
to depend upon it, to the exclusion of all other remedies. 
This preparation of iron is used ad lihifum in gyngecological 
surgery, without injury, and I am satisfied that it is equally 
as beneficial and harmless in ordinary uteriue hemorrhage. 

I am of the opinion that the benefit derived from this 
plan of treatment is not altogether from the styptic action 
of the iron, but that a portion of it arises from the intoler- 



Pekiscope. 295 

ance of the uterus to any foreign substance in its cavity, 
tlie muscular fibres contracting forcibly to expel the in- 
truder, and I cannot see why an ordinary case of uterine 
hemorrhage could not be treated successfully by non-medi- 
cated tents alone. — Dr. M. B. Barker, in Med. and Surg. 
Bep 



Xote on Delivery of the Placenta. 

The diversity of usage which still obtains in the man- 
agement of the third stage of natural labor, prompts 
this brief note, in the hope of eliciting the views and prac- 
tice of the Society. 

The points to which I wish especially to invite atten- 
tion are the method and the time of placental delivery. 
These comprise a larger part of the treatment of the pla- 
cental stage, the management of which is, perhaps, the 
most important office of the obstetrician in the conduct of 
natural labor. 

The preferred method of delivering the placenta is 
that of Crede. of Leipsig. In Germany this method is now 
used to the exclusion of almost every other, and it would 
seem that so eminently judicious and rational a procedure 
could not fail of universal adoption. That such is not yet 
the case, is possibly due to the fact that in many of the 
standard works on obstetrics, the Credean method, if men- 
tioned at all, is more or less imperfectly stated. The Cre- 
dean procedure is not identical, as claimed l^y Barnes, with 
that taught by Hardy and McClintock, and long practiced 
in England. It differs essentially from the practice of the 
Dublin school, which consists in expelling the afterbirth by 
crowding the uterus downward in the pelvic cavity by 
pressure on the fundus. It does not contemplate the mere 
expression of the placenta by compressing a uterus still 
flaccid from inertia, as might be inferred from the state- 
ment of one of the latest text-books. On the contrary, 
the essence of the German method is compression of the 
uterus during contraction, and with but slight downward 
pressure. 

The Credean method is practiced as follows : The ob- 
stetrician laying his hand flat upon the abdomen of the 
patient, stimulates the uterus to contract by moving the 
abdominal wall in a circular manner over the uterus: The 
friction, gentle at first, is increased till the uterus contracts. 
At the height of the uterine contraction the upper segment 
of the uterus is firmly grasped with the hand, the fingers 



296 The Peoria Medical Monthly. 

over the posterior, and thumb over the anterior surface. 
The phicenta is thus expressed from the uterus, only 
enough downward pressure being used in the axis of the 
uterus to maintain a firm grasp. Failing in the first at- 
tempt, the compression may be repeated with each uterine 
contraction till successful, friction being continued mean- 
time to maintain the retraction thus far accomplished, and 
to provoke further uterine efforts. 

It is the peculiar merit of this method that it, more 
closely than any other, imitates the natural process of pla- 
cental expulsion. Moreover, it is designed to supplement 
the expulsive efforts of the uterus, not to replace them. It 
maintains firm retraction of the uterus till the afterbirth 
is expelled, keeps the uterine vessels securely ligated, and 
prevents the formation of deep coagula in the uterine 
sinuses. It favors, more than any other plan, permanent 
uterine retraction after the delivery of the placenta. Po- 
tent for good, it is incapable of harm. 

Some practice is undoubtedly necessary to the utmost 
facility in this procedure, but the knack once acquired, 
other measures will be very rarely called for. 

With reference to the time of placental delivery, the 
prevailing practice, in the judgment of the writer, favors 
too long delay. Dr. Playfair, follow^ing the teachings of 
McClintock, says that no attempt should be made at deliv- 
ery of the placenta till twenty minutes after the expulsion 
of the child. Certain other obstetric w riters sanction even 
longer delay. The arguments of Dr. Playfair in support of 
his practice are that time is thus allowed for recovery from 
the shock or exhaustion of the second stage, for the separ- 
ation of the placenta, and for the formation of coagula in 
the uterine sinuses. While these would be valid reasons 
for delay under the old practice of placental extraction, 
they do not forbid early resort to the Credean method. As 
a rule, after the ligation of the cord, the sooner the uterus 
can be made to cast oat the placenta the better for the 
patient. 

There is surely no exhaustion of the uterus when it 
can be provoked to contract by gentle friction. Again, the 
very agency bj^ w^hich separation of the placenta is accom- 
plished is uterine contraction and retraction. Against the 
dangers of post-partum hemorrhage, the chief security lies 
in the ligation of the uterine vessels by retraction of the 
muscular structures. Coagula in the uterine sinuses are a 
feeble barrier against hemorrhage. Moreover, thrombi ex- 
tending into the intermuscular portion of the uterine veins 
are a positive source of danger, from their liability to in- 



Periscope. "^' 

fection. Promptness, again, facilitates delivery. By too 
long waiting the way may be narrowed by the contraction 
of Bandl's ring, and^the difficulty of expulsion be thus in- 
creased. As a rule, then, the placenta should be expelled 
as soon as its function is ended ; that is, as soon as the in- 
fantile circulation is established and the cord divided. 

A word with reference to the use of ergot may not be 
out of place. Prof. Lusk disparages the exhibition of this 
drug before the afterbirth is delivered, owing to its ten- 
dency to induce so-called hour-glass contraction. In my 
practice a drachm of the fluid extract of ergot is given by 
the mouth in every case — or its equivalent hypodermically 
—as the head passes the vulva. Under the above manage- 
ment of the placenta, it is expelled before the effect of the 
drug is developed. 1 should be unwilling to sacrifice the 
advantage gained by prompt and complete retraction oi 
the uterus, through fear of a possible danger so seldom 
realized. 

In conclusion, I submit the following summary : 

Use constant friction or uterine massage after the de- 
livery of the head, for the double purpose of maintaining 
retraction and provoking uterine effort. 

Supplement the uterine efforts, if need be, by com- 
pression. 

After the placental expulsion, continue friction till re- 
traction is complete and permanent. 

Use ergot on the birth of the head to promote the 
prompt and perfect completion of the third stage. Aim to 
deliver the placenta, as a rule, directly after, not betore, 
the ligation and division of the cord.— TA^' Proceedings. 



Salicylate of Soda (1) In Tonsillitis, and (2) As a Local Applica- 
tion in Gout. 

Edward Mackey, M. D., Brighton, contributes the fol- 
lowing to the British Medical Journal: 

1. A paper by Mr. Hormazdji, recently published m a 
contemporary, treats of a clinical point deserving, I think, 
more attention than it has yet received— I refer to the 
value of salicylates in tonsillitis. The good effect of these 
salts, when prescribed for that complaint, has been illus- 
trated by the clinical records of Fowler, L. Browne, Hunt, 
and others, in the Journal of one or two years back; but is 
not yet so widely recognized as to be independent of fur- 
ther evidence. My personal experience is not large, but is 
based upon several very severe and acute cases m which 
ulceration had occurred before salicylate of soda had been 
administered. It was then given in ten-grain doses every 



29S The Peoria Medical Monthly. 

two to four hours, and in each case I was struck, not only 
by the lessening of the pyrexia, but also by the relief cred- 
ited by patients themselves to each dose of the remedy — 
much as one almost expects to hear of it in acute rheu- 
matism. One surgeon, himself a sufferer, notes marked 
relief within twenty minutes {Mid. Med. MisceL, No. 6). 

Hormazdji recommends twenty-grain doses; and hav- 
ing noted relief in fifty-seven cases of tonsillitis caused by 
cold and damp, concludes that such cases give the best 
results, and that, when the malady arises from bad air or 
drainage, it is less amendable. This seems reasonable, but 
is not exactly my experience. For instance, of a family of 
nine children living in a house too small for them, and 
defective as to drainage, five in succession got severe acute 
tonsillitis, several having a temperature over 103 degrees 
Fahrenheit and nocturnal delirium, and all going on to 
more or less ulceration. The earlier cases got a calomel 
purge, small frequent doses of aconite and potash-chlorate, 
sulphurous spray, a benzoin inhalation, and ice: later, iron; 
they were relieved within thirty-six hours, but all relapsed 
on the third day. It was only when the sixth child — a 
delicate one — was attacked, that I had become aware of 
this use of the salicylates, when I found him suffering with 
severe throat symptoms like the others, I ordered, after his 
purge, five grains of the soda salt every two hours in liquor 
ammonite citratis. The boy, wdio expected the same illness 
he had seen his brothers and sisters go through, expressed 
with surprise relief from the first few doses, was free from 
pain in tw' enty-four hours, had a very slight patch of ulcer- 
ation, and no relapse. (The above prescription, which I 
gave this patient, should form a clear colorless solution, 
wdiich agrees well, but, when dispensed by some chemists, 
I have known it turn brown, and cause irritation and 
vomiting; for this I have no satisfactory explanation.) 
Since this note w^as w-ritten some half-dozen other cases of 
ulcerative tonsilitis have show^n similar good results with 
the same remedy; of course, when actual suppuration 
(quinsjO has occurred, equal relief will not be expected. 

2. N., a man nearly 70, with what he called "com- 
pressed gout,"' show^ed an inflamed and swollen great toe^ 
and complained of characteristic burning pain and tension 
in it and in the wdiole foot. He had several attacks before, 
never so bad as this; and had no sleep for three nights; 
overw^orried lately; he had probably exceeded in sherry; he 
was thin, weakly, and subject to diarrhoea. I ordered a 
lotion containing salicylate, two drachms to eight ounces 
of water with one or two drachms of laudanum, to be 



Periscope. 299 

applied warm on lint with oiled silk; also ten grains of the 
salt internally every four hours. The lotion arrived first, 
9 p. m., and was applied at once; in ten minutes the pain 
was relieved, the patient went to sleep, and had a good 
night; the medicine w^as not commenced till next day. He 
kept in bed, as ordered, three days, and had no severe 
return; he went out too soon, and ten days after got a par- 
tial relapse, which yielded to the same remedy. 

Another gentleman, also nearly 70, and long subject to 
irregular gouty attacks, got a sudden acute development of 
the malady in one finger and an elbow-joint, a slighter one 
in the big toe; for twenty-four hours he "objected to any 
local application as too troublesome, and took iodide of 
potassium with magnesia, etc., on the second day however, 
he was glad to apply the salicylate lotion, and reported 
quick and marked relief from it. Since the date of these 
cases, similar ones have been recorded by other observers. 

In a third case, of a young married lady with very 
marked gouty family history, the immediate cause of 
desiring advice was an eruption of lichen planus on the 
arm. A salicylate lotion, containing also a little prussic 
acid, suited this patient extremely well; though in a more 
chronic case of the same kind, but with extensive systemic 
disturbance (as usually associated with this eruption) it 
proved of no more service than other remedies. Its spe- 
cialty lies in relieving gouty and rheumatic joints, which 
it seems to do even better than the ordinary alkaline 
compounds. 



Ear-aclie. 

Another way of stating that atropia paralyzes a periph- 
eral sensery nerve is given by Dr. A. D. Williams in Mar- 
tin's Chemists' and Drugyids Bullet iit. He says, what phy- 
sician has not been puzzled to know what to do for the con- 
stantly recurring ear-aches of children at night ? The most 
effectual treatment, and the one that has stood the test of 
years, is the local application of a solution of the sulphate 
of atropia. Not a single case but has yielded at once. The 
solution is to be simply dropped into the painful ear and 
allowed to remain there from ten to fifteen minutes. Then 
it is made to run out by turning the head over, then being 
wiped with a dry rag. The solution may be warmed to 
prevent shock. From three to five drops should be used at 
a time. The strength of the solution must vary according 
to the age of the child. Under three years, one grain to 
the ounce, and over ten years four grains to the ounce of 



300 The Peoria Medical Monthly. 

water. In growing persons almost any strength may be 
■used. All ages will bear a stronger solution in the ear than 
in the eye. The application should be repeated as often as 
may be necessary. Usually a few applications will stop 
the pain. In acute suppurative inflammation of the mid- 
dle ear, and acute inflammation of the external meatus, 
atropia will only slightly imlliate the suffering, but in the 
recurring nocturnal ear-aches of children it is practically a 
specific. — Chicago Med. Bevicir. 



Clinical Remarks on Boracic Acid. 

For a long series of years we have been drawing the 
attention of the profession to what we have been pleased 
to term a rational treatment of external diseases of the eye, 
and each year has been marked by decadence of the old 
asti'ingent-caustic plan. 

We belive it was Lister who popularized boracic acid, 
for a long time a secret remedy in Belgium. 

Worlomont claims more benefit from its use in exter- 
nal ocular affections than from all other remedies. It has 
found other strong advocates, among whom we maj' men- 
tion, Panas, of Paris ; Theobold, of Baltimore ; and Masse, 
of Bordeaux. 

Proba])ly now a large number of oculists use boracic 
acid more or less, and it is without doubt a remedy of ver}^ 
general application and of great utilitj^ The basis of its 
action is without doubt its toxic eff'ect on parasitic growths, 
and hence its value in catarrhal and purulent affections, 
most clearly demonstrated in purulent otitis media, where 
the most brilliant results have been shown. 

We are not aware that great stress has been laid on its 
use in blepharitis marginalis. though we know it has been 
used for this disease. The fact is, since the relation be- 
tween strain on the eye and blepharitis marginalis has 
become known, and that the great remedy in connection 
of the anomaly in structure or balance of muscles, ungu- 
ents have lost largely of their importance. All the old 
pencillings with nitrate of silver, smearing with nasty mer- 
curial salves have practically gone b}^ 

For two or three years in both private and dispensary 
practice, when we have written for anything in this, it has 
been three per cent or four per cent of boracic acid in vas- 
eline (15 to 20 grs. to the oz.), and we can vouch for its 
answering every purpose. 

We never treat a case of purulency now without con- 
fining the cleansing of the eyes to solutions of boracic acid, 



Periscope. 301 

and for the milder forms in which we are unable to per- 
sonally carry out the treatment we allow nothing else. In 
the severe form we api^ly once a day, the yellow oxide and 
vaseline as used for so many years by myself, and perhaps 
in addition, a solution of eserine. 

It is quite generally known now that antiseptic pre- 
cautions have obliterated in both hospital and private prac- 
tice, the ophthalmia of new-born children, and as a pro- 
phylactic we must earnestly advise the exclusive use of 
boracic acid solutions, and the entire discarding of carbolic 
acid, since it is extremely annoying and practicalh^ demon- 
strated to be valueless as an antiseptic, and we need not 
say astringents should be treated in the same way. 

Boracic acid, moreover, can claim the virtue of being 
inert and painless. 

It is certainly firmly established now that a true puru- 
lent conjunctivitis is due to the presence of a nicro-organ- 
ism definitely fixed and known, and any treatment or rem- 
edies to be rational must be parasiticidal. We still adhere 
(and all investigations confirm the view) to our so often 
asserted opinion, that mercury is the great antiseptic, but 
there are conditions and circumstances that render other 
remedies better applicable. We firmly believe that the 
strikingly efficient action of mercury in catarrhal conjunc- 
tivitis and trachoma, demonstrate the parasitic nature of 
these affections, though now we have had found for us the 
microbe of trachoma by Hubert Sattler of Erlangen. — Dr. 
W, W. Seely in Lancet and Clinic. 



Cliroiiic Malarial Hpematuria. 

Prof. Orendorf recommends the use of strychnia under 
the skin in this disease. This drug, he says, stands at the 
head of the vaso-motor stimulants, and is especially useful 
in low vascular tension. It should be administered in full 
doses, that the relaxed vessels may be made so tense as to 
prevent exudation. By full. doses is meant the amount re- 
quired to produce the desired effect ; which is to stop leak- 
age. Therefore, if one-thirtieth of a grain does not suf- 
fice, push it to one-twentieth, to one-fifteenth, and then to 
one-tenth ; repeating sufficiently often to secure and keep 
secured the physiological action of the drug. — Chicago 
Medical Beview. 



Alexander {Arcdiv. of Dermatol) cites three cases in 
which inflammatory i^ustules developed under the use of 
sulphide of calcium and disappeared after its discontinu- 
ance. 



ti3::e] 



Peoria Medical Monthly. 



THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jefferson Street, - . _ . PEOKIA, ILL. 

*** A.11 excliauges, books for review, and communications must be addressed to tlie 
Editor and Fubllsiier. 

**-.sTlie publicution day of tliis journal is on or about tlie loth of each month 
Hi^^To subscribers! A pencil mark at this place indicates that the timeof your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



^(Utofial gcpvtm^ttt. 



Notes and Coiiiiiieiits. 

A colored woman aged 108, died recently on Long 
Island. 

Chicago Medical College has about 160 students for the 
new term. 

Prof. Hildebrandt of Konigsberg, the distinguished 
gynecologist, is dead. 

Drs. Yandell and McMurtry succeed Dr. Holland as 
editors of the LouisviUe Medical News. 

Idiopathic Emetocatharsis is the name given to cholera 
morbus by a writer in an Atlantic journal. 

Of seventy-eight graduates of Yale who died in 1881, 
the average age Avas 77 years. The oldest was 96. 

Dr. Hauxhurst, of Battle Creek, Mich., was a disbeliever 
in vaccination. He died in Paris of small-pox. Enough 
said. 

Rush College, Chicago, opened with over 470 students. 
The largest number at the opening of any term in its his- 
tory. 

" Doctors and mackerel," says the Boston Post, "have 
this in common ; they are seldom caught out of their own 
schools." 



Editorial Department. 303 

The new year approaches, kind readers. We hope it 
will remind some of 3'ou of yonr renewal to this journal 
now due. 

The College of Physicians and Surgeons. Chicago, has 
matriculated 138, most of whom take the three years 
graded course. 

The formula on page 262 of our October issue should 
be corrected to read — 

Terebin., ad 4 ounces. 

A case of pruritus and urticaria was cured by jabo- 
randi, five minims of the fluid extract being administered 
three times a day. 

Dr. J. J. Woodward has returned from his trip to Eu- 
rope. We are sorry to learn that his health was not 
greatly, benefited thereby. 

Dr. H. Pidoux, the distinguished co-laborer with Trous- 
seau in the authorship of the " Treatise on Therapeutics," 
died on the 4th of August. 

The president of Mexico has ordered a monthly pay- 
ment of $30 to be made to a lady of distinction who has 
engaged in the study of medicine. 

We will try to give a history of the fight in Cook 
County Hospital in a future number. We know it will be 
of interest to many of our readers. 

Philadelphia was visited during the past spring by an 
influenza of extraordinary severity, causing many deaths 
from pneumonia and other forms of disease. 

Dr. T. Gaillard Thomas has accepted his former posi- 
tion as Clinical Professor of Diseases of Women in the 
College of Ph3\sicians and Surgeons, Xew York. 

An abortion case was lately tried in Chicago, in which 
a post-mortem showed that the victim had never been 
pregnant. The girl died from metro-peritonitis. 

Prof. Yolkmann has declined to leave Halle to become 
the succssor of Langenbeck in Berlin. At last accounts, 
Prof. Bergmann, of Wurzburg, had been elected to the 
Tacancy. 



304 The Peoria Medical Monthly. 

Dr. B. W. Richardson, the distinguished advocate of 
temperance in England, has lately presided at a meeting at 
Exeter Hall to organize a society for the suppression of 
juvenile smoking. 

A society of young men has been formed in England 
for the purpose of inducing females to abandon all modes 
of dress inimical to health and hygiene, and to the proper 
development of the human form. 

Cholera is still making fearful ravages. The deaths in 
Manilla alone during a part of September averaged 300 
daily. In the province of Yloilo there were 4,550 deaths 
during the last two weeks of August. 

Dr. Joseph M. Toner, of Washington City, has donated 
his library to the U. S. government. The entire collection 
of books, pamphlets, manuscripts and periodicals, amount 
to twenty or twent3"-five thousand volumes. 

Stir up! Stir up! Write for this journal; report a 
case; give your successful treatment. Ventilate your med- 
ical or ethical ideas. (You would feel insulted should any 
one insinuate that ijoii have no ideas and can't write.) 

Dr. A. W. Smyth, of New^ Orleans, to whom belongs 
the credit of having performed the only permanently suc- 
cessful ligation of the innominate artery, has recently been 
appointed suiDcrintendent of the U. S. mint in that city. 

New York has a second post-graduate college. The 
Detroit Lancet thinks New^ York has room for forty or fifty 
more, and that they are a good thing. The next thing w^e 
expect to hear is that Detroit has started a few of the same 
kind. 

During the last ten days of August there occurred in 
Yokohama and vicinity 465 new cases of cholera and 281 
deaths. The total number of cases since the commence- 
ment of the epidemic (April last) reaches 3,509, and the 
deaths 2,223. 

Dr. Ralph Walsh has temporarilj^ suspended the pub- 
lication of his valuable Betrospect on account of increased 
duties as director of the National Vaccine Establishment. 



Editorial Departmeint. 305 

We hope the Retrospect will appear again on our table 
before many moons. 

Should babies' milk be boiled? asks the College and 
Cliyiical Becord. Now this shows how much the subject of 
infant dietetics is being over-studied. We cling to the old- 
fashioned view that babies should not be milked anyway, 
much less have their milk boiled. 

The commissioner of education of the United States 
reports that there are now 72 regular, 6 eclectic and 12 
homoeopathic medical colleges in the country. We believe 
that the numbers given might be increased by one-half 
and go very wide of the mark. 

An English Duchess once sent for the notedly unceri- 
monious Dr. Jepson. The Dr. was so off-hand with her 
grace that she turned angrily upon him and demanded if 
he ** knew to whom he was speaking? " " Oh yes," replied 
the doctor, ''to an old woman with the belly-ache." 

A complicated case is reported from Fort Worth, Texas. 
An irregular practitioner made a diagnosis of '" Erysipelas 
from the toes to the knees ; measles from the knees to the 
waist, and seven years itch from the waist to the top of the 
head." A number of persons whose curiosity impelled 
them to visit this phenomenon, contracted small-pox. 

A New York doctor, worried, worn and weary 

With dust and heat and circumstances dreary, 
Eesolved to rusticate and go a tisliing, 
And so he bids .John tell all persons wishing 

Plis counsel that a case of ichthyosis 

Has called him out of town in consultation. 

His patients set him down a second Moses, 

And propagate abroad their admiration. 

— Pacific Med. and Surg. Journal. 

The charts we offer are a source of great annoyance to 
us, because so many send for them that we are always in 
hot water to get enough to supply the demand, and we dis- 
like to ask our friends to wait a few days for them. Still 
it is the kind of hot water we like to be in, for it shows 
how fast our journal is spreading, and we hope the shower 
will continue. We will do our best to send the charts at 
once, but if we can't, do not be afraid; you will get them 
as soon as we can get them. 



306 The Peoria Medical Monthly. 

Dr. Fotbergill thinks that the American Medical Asso- 
ciation had better go "a little slow"' about establishing the 
proposed journal of the American Medical Association. 
He thinks the management of the BrifisJi Medical Jouyual 
has been very poor, and that it is really a failure so far as 
its object to bind the profession together and unite their 
interests is concerned. The editor is given so much power, 
or has usurped it, that the association is kicking strongly 
against it. We are in favor of the new journal in prefer- 
ence to the old cumbersome volume of transactions, but 
we admit some doubts as to its longevity and perpetuity. 

The Articulations. — The following arrangement of 
the names descriptive of the various articulations, is Ijy 
Dr. James L. Little. Professor of Surgery in the University 
of Vermont, and of Clinical Surgery in the University of 
New York : 

Enartlirosis, bone to bone, 

Femur, Acetabulum; 
Ginn,lymus, the liino-e I see. 

Forwards, backwards swings the knee. 
Arthrodia, near the end. 

Glide along- the foot and hand ; 
Sj'nchondrosis, we allege, 

Calls for costal cartilage; 
Syndesmosis^-ligament, 

Binding bone to bone is meant. 
Syssarcosis — lower jaw. 

Flesh from ribs to scapula. 
Suture, a stitch withal. 

Coronal, lamdoid, sagittal. 
Harmon ia — Tipperarj^ 

Rhymes with supramaxillary. 
Schindylesis — plowing done — 

Vomer in the sphenoid bone. 
Gomphosis sets all things right ; 

Tooth in socket pretty tight. 

— MicJii(jan Med. Xeivs. 

We hope sufficient enthusiasm will be aroused in the 
editorial breasts of our many exchanges, to work up a full 
meeting of the Association of American Medical Editors 
at the Cleveland meeting next year. In union there is 
strength, and by working in harmony and to the same ends, 
this association can exert an influence in the profession 
not excelled by the American Medical Association itself. 
Besides this, from a meeting of this kind, if well attended 
and heartily entered into, not one could go away without 
some thought or idea that would prove invaluable to his 



Editorial Department. 307 

journal. By all means, brother editors, turn out and bring 
a short paper on some i3ractical subject with you. 

The ever bright and always pertinent J//c7//^</>^ Medical 
News has a hard task on its hands, that of regulating and 
correcting and chastising the medical faculty of Ann Ar- 
bor, and, it might be added, defending itself from the back- 
kicks of said faculty. But the News needs no backer in 
the fight ; it is always able to take care of itself. The 
medical department of the University of Michigan is al- 
ways in hot water about something, and the best thing, 
perhaps, that could be done under the circumstances would 
be to sink the leaky old craft in Lake Michigan and .begin 
over again. The medical j)ublic, we opine, is about tired of 
reading endless accounts of its squabbles, or wading 
through pamphlets scattered promiscuously around at 
meetings of various medical societies. 



Some Things That May Interest You. 

FOR SALE— Retail Drug Store in live town, 18 miles from St. Louis. 
Also one of the best locations in the state for a good physician, with house 
(9 rooms), good stable, one-half acre land and a good practice. Reasons, poor 
health. Address, . F. A. Sabin, M. D., 

Troy, Madison Co., Illinois. 

St. Louis. Aug. 25, 1883. 

Surgical practice does not frequently profler the oportunity of employing 
nervo-tonic remedies, and therefore I am perhaps not competent to fully judge 
the therapeutic virtues of Celerina, a compound lately introduced by J. C. Rich- 
ardson, Escj., of this city. I have however used it, and with very satisfactory 
results in at least twenty appropriate cases, and feel persuaded that it develops 
most happy actions, and that it deserves the attention of medical practitioners, 
more especially of those employed in the treatment of nervous afflictions. I 
shall certainlv continue to test it more fully, and report my observations in due 
time. " Loris Bauer, M. D., M. R. C. S. Engl. 

Professor of Surgery in and Dean of College of Physicians and Surgeons, St. 

Louis, Mo. 

CiiTCAGO, III. 

I have been using Celerina in nervous diseases, particularly functional 
diseases of the heart, for some time, and I am satisfied that as now prepared it is 
a useful remedv. E. Fletcher Ixgals, M. D., 

Prof Physiology, Hygiene and Clinical Medicine, Medical College of Indiana, 

Indianapolis, Indiana. 

St. Louis, Aug. 25, 1882. 

The concentrated extract of Pinus Canadensis has established for itself the 
most unqualified commendation as an astringent, and it scarcely requires any 
further affirmation on my part. 

Louis Bauer, M. D., M. R. C. S. Engl. 
Prof, of Surgery in and Dean of College of Physicians and Surgeons, St. Louis, 

Missouri. 

St. Louis, Mo. 

Kennedy's Compound Extract Pinus Canadensis received. It is the only 
astringent I use in the throat. I consider it a verv valuable preparation. 

TlIOS. F. RUMBOLD, M. D. 



308 The Peoria Medical Mo^'THLY. 

Brazeau, Perry Co., Mo., Nov. 5, 1882. 
Editor Peoria Medical MontJilij : 

Dr. Suloff, in the October number of the Monthhj asks 
" somebody to suggest a good method for collecting bills." 
My experience in that important branch of our profession 
has been chiefly at Murphysboro, a mining town in Southern 
Illinois. I soon realized that collecting bills, like all other 
duties of the practitioner, required judgment and tact ; 
the character and j^ecuniary condition of our customers 
must be studied as closely as the temperament and idiosyn- 
crasies of our i^atients. There is one class of customers 
that need very little attention here, viz: those that really 
pay their bills without the advice or aid of their physicians. 
It matters not if you are a Greenbacker, nor W'hat your 
views were of Illinois' proposed " Truck-bill." If you can- 
not get cash, take something else. Among men working 
at public work, I very often took orders on their pay- 
masters. 

It is much harder for them to refuse their signatures 
than to say that they have no money and promise to pay 
'■ next pay-day." 

It is better, of course, to take a number of small 
orders than one large one. Among your producing 
customers be very accomodating ; take any product which 
you can make use of yourself, or sell. 

I have sometimes found it expedient (in Illinois) to sue 
for labor before a remote esquire, where it would be in- 
convenient for the defendant to appear in answer to his 
summons, get a "labor judgment" and proceed accordingly. 
Don't let your bills get too old ; they deteiiorate by stand- 
ing open. 

Don't be afraid of losing practice by collecting closely, 
for it is one of the best ways of holding it. Your patient 
probably ow^es all the other doctors in town, and sends for 
you because he has paid you, and consequently feels sure 
that you will attend him. Attend to your own collecting ; 
^'ou cannot trust to agents. Finally, we will meet with 
some that no art can reach ; those we had better turn over 
to nature, especially when they get sick. 

M. F. Rolens, M. D. 



The Peoria 
MEDICAL MONTHLY. 



Vol. hi. DECEMBER, 1882. ^No. 8. 



©riglual (ffiommuttiatianisi. 



Art. I. — Bacteria. By Romai^je J. Curtiss, M. D., Joliet, 111. 

The following is taken from the Medical and Surgical 
Beporter, and as it is put forth with some assurance, and is 
certainly widely circulated, it merits attention: 

THE LATEST ABOUT BACTERIA. 

This time it comes from America. 

Dr. Formad, of Philadelphia, has made some experi- 
ments, from which he is led to believe that, contrary to the 
generally accepted view, bacteria are not the cause per se 
•of disease, but are merel}" the vehicle of contagion, the 
means by which the poison of certain diseases is carried 
from one organism to another. He has found the tubercle 
bacilli of Koch, or, at least, bodies identical with them, in 
the sputa of nonphthisical patients. 

He has taken matter infested with the diphtheritic 
micrococci (first demonstrated by Professor Wood and 
himself), and has succeeded in producing the disease in 
animals, while micrococci from the very same specimen, 
after a thorough ivashing in plain water, were perfectly 
harmless. 

He believes that bacteria exist in all nature, and that, 
even when charged with the elements of disease, they can- 
not produce the disease unless they find a resting place in 
some body that is, on account of some unexplained condi- 



310 The Peoria Medical Monthly. 

tions, a suitable pasture for the growth and development 
of the particular disease. 

This view, which seems to be a very rational one, has 
two important practical bearings. 

In the first place, it teaches us very forcibly the value 
of water as a disinfectant; and, in the second place, it 
lends much additional force to the idea that infectious 
diseases are due to chemical influences, which theory, if 
demonstrated, w^ll do much toward increasing the potency 
of our therapeutic resources. 

If these bacteria carry certain elements that are capa- 
ble of producing disease, it is not unreasonable to hope that 
chemistry will step in and tell us the chemical nature of 
these poisons: from this standpoint it will be but a step to 
name the chemical that will prove the antidote, and by this 
process can we arrive at the most rational treatment of in- 
fectious diseases. Dr. Formad promises to have more to 
say on this subject, and we look forward to his researches 
with interest, for it would seem that he is on the right 
track. 

These experiments of Dr. Formad are certainly very 
novel in view of his former publications on investigations 
of the causes of diphtheria, in conjunction with Dr. Wood. 
One claim for these experiments and conclusions must be 
granted, and may be granted without particular detriment 
to the welfare of experimental science, viz: it is the very 
" latest about bacteria." In view of the established science 
about bacteria, it would appear that these experiments are 
a little too late. In fact I know of nothing in human oc- 
currence with which to compare it in the virtue of lateness, 
except the lateness of the hour in which Rip Van Winkle 
got up to breakfast. When Rip woke up he was twenty 
years behind the w^orld. This new theory may not be 
twenty years behind, but is decidedly too late. 

To appreciate the value of this late publication (is it 
not too early ?) I will compare the conclusions, as given, 
with the known facts about bacteria which are established 
as science by experiments: 

First, bacteria are not the cause of disease, but are 
merely the vehicle of contagion, and this contagion is due 
to or is chemical influence." 

The chemical theory of contagion, and fermentation, 
and putrefaction, was originated by Liebig. This great 



"^ Original Communications. 311 

chemist recognized the fact that the air, soil and water 
contained the dead organic matter of the earth, which was 
in a condition of putrefaction and oxidation, preparatory 
to being again taken up by living animals and plants. 
Liebig thought that particles of this putrefying matter, 
which continually occupied the air, water and soil, got into 
fermentable matter and caused the specific ferments, as 
well as putrefaction, and also invaded living plants and 
animals, and caused disease. 

Now the experiments of Tyndall, Pasteur, Koch and 
Drysdale have established the truth that no extract from 
the air, water or soil, or from putrefying matter, or fer- 
menting matter, or from disease tissue, or excretion or se- 
cretion, can cause any specific disease or specific fermenta- 
tion, or ammoniacal fermentation (putrefaction), unless 
bacteria be living and thriving in the extract with which 
the experiments are made, or unless their spores are there. 
The washings of bacteria and the fluids in which they live, 
and the chemical extracts, and the filtered liquor from all 
kinds of bacteria, disease germs and otherwise, have been 
inoculated thousands of times and have failed to cause 
disease ; nor will any such preparation, washings or ex- 
tracts frony the specific bacteria of any specific ferment, set 
up in any fermentable fluid any fermentation. 

The fact is as much a matter of science as is gravita- 
tion, that the specific agents of fermentations and diseases 
has the power of multiplying itself. Any late discovery 
about bacteria must conform to this general law or must 
suff'er defeat. 

Dr. Formad says the washings contain the specific 
chemical agent of disease which is carried by bacteria. 

To make this assertion fit the general law it is neces- 
sary to assume that bacteria have the power of manufac- 
turing the dirt on their faces which is washed away by Dr. 
Formad. As each bacterium divides by fission, or deposits 
its spores, enough chemical ferment of disease and putre- 
faction is manufactured to give the new bacterium or new 
spore a " setting out." I have heard of children being born 
with silver spoons in their mouths, but I have never heard 



312 The Peoria Medical Monthly. 

that children are born with a specimen of the same sort of 
dirt on their heels or under their finger nails which their 
parents may have carried. 

Dr. Formad does not claim that the dirt on the bodies 
of bacteria, which constitute contagion, is manufactured 
by the bacteria themselves as they develop. A theory of 
this kind was started some years ago w^hich seemed very 
plausible. It, at least, agreed so nearly with the general 
laws which govern plant growth as to merit the decrees of 
common sense. The contagion's principle was assumed to 
be a product of bacteria (not an accidental dirtiness) and 
was an alkaloid, the product of bacteria in the same sense 
that quinia is of the cinchona tree. This theory, could 
adapt itself to the general law that contagion can multiply 
itself. But experiment proved that this theory was not 
true. The alkaloid (?) was extracted from all sorts of bac- 
teria and put into fermentable matter and inoculated into 
animals, but it wouldn't work. No ferment could be set up 
by it, nor could any specific disease be caused by it. 

It was found, however, that the specific, so-called, alka- 
loid was a poison, and animals inoculated with it took a 
diarrhoea and had some fever. The concoctors of this de- 
coction, therefore, thought if it wouldn't kill people per- 
haps it might cure them, and this noxious stuff was actually 
turned into a remedy and is now manufactured and sold as 
a medicine under the name of pyrexin. 

It may be said that the principle by which this was 
done would tickle a homoeopathic. Dr. Formad, unfortun- 
ately, does not inform the public what he did with his 
washings. 

If he had inoculated the w^ashed bacteria with no 
effect, and then inoculated the washings with the effect of 
causing diphtheria, perhaps other experimenters might re- 
peat the proceeding. So far as the experiments have gone 
the publication is of no more scientific value than is the 
advertisement of a washer woman. 

2. " He believes that bacteria exist in all nature," says 
the record, '' and that even when charged with the elements 
of disease they cannot produce the disease unless the}^ find 



Original Communications. 313 

a resting place in some body that is, on account of some 
unexplained conditions, a suitable pasture for the growth 
^nd development of particular diseases." 

Dr. Formad almost believes what is scientifically 
known about bacteria. These spores are proved to com- 
pose the "floating matter of the air." If these spores fall 
into dead organic matter they set in fermentation or putre- 
faction by germinating and multiplying. If the spores of 
specific diseases get into the body (contagion) they go 
through the same process and produce disease. 

Bacteria live in dead and live organic matter just so 
far as dead and live organic matter is distributed through- 
out "all nature" and no further. 

A fact that is proven is that different kinds of bacteria 
produce different effects, whether in ferments or disease. 
The yeast foruke will always produce alcohol ; the Micro- 
coccus villi will always produce vinegar; the micrococcus urea 
will always produce the ammoniacal fermentation of urine; 
the micrococcus vaccince will always produce kine-pox and 
its modified form the small-pox ; and the bacillus of tubercle 
will always cause phthisis ; and the bacillus anfhracis will 
always cause malignant pustule. The general law is that 
the different effects of bacteria are caused by different 
kinds of bacteria. It requires a considerable stretch of the 
imagination to believe that different kinds of bacteria wear 
different kinds of dirt on their faces. 

This same law ought to hold good in relation to other 
parasites. Somebody ought to wash itch mites and note 
the result: What kind of dirt does the cysticercus cellulosce 
carry on his crown of thorns? and if these parasites could 
be caught and washed would it make them harmless? 

Hereafter the generic name for the parasites of disease 
and the agents of fermentation must be the title of the 
"great unwashed." There is no necessity (unless a man 
wants to take in washing) of substituting any secondary 
power, force, matter, agent, dirt, alkaloid, or anything else 
in the place of the physiological power or forces of bacteria 
as agents of fermentation or disease. The aggregate bulk 
'Of bacteria, in any disease or ferment, amounts to a great 



314 The Peoria Medical Monthly, 

quantity. It is estimated that were the ocean a proper 
food medium that one bacterium, by the ordinary laws of 
his reproductive powers, would fUl the ocean full of bacte- 
ria in five days. This great bulk and rapid reproduction 
must require matter and force from some source to cause 
it, or else something can be made out of nothing. 

We must regard bacteria as living things. They are 
neither animals nor plants, but partake of the nature of 
both, and Haeckle has therefore classed them in a new 
kingdom which he calls Protista. 

If bacteria are living things they live by eating, and 
this fact explains all the good and all the mischief they 
can do. 

When any living thing takes food it transforms matter 
and force. Part of this matter and force goes into the 
structure and heat of the living eater, and part into its 
works and heat, and part into its formed materials. The 
formed materials represent the chemical structure of the 
food after it has passed through the living thing. When 
a bacterium UneoJa eats the dead in graves the formed 
material is the albuminoid and ammoniacal compounds 
which result from "decomposition;" when a micrococcus vini 
eats alcohol the formed material is vinegar; when the 
ioruJcc eats sweetened water the product is alcohol. 

The same laws hold good to the production of all the 
metamorphoses of tissue wiiich are the work of bacteria, 
and are called pathological products, the type of which is 
tubercle. It has been abundantly verified that bacteria 
have an action upon dead and living organic matter. It is 
not verified that anything they carry with them, as dirts, 
or anything they make as structural elements of them- 
selves, has any effect on dead or living matter; but the 
formed materials of many of them, as alcohol and vinegar, 
are quite effective. 

The physicological action of bacteria is sufficient, then, 
to account in full for all the phenomena that bacteria are 
known to come, and, this being tried, all substitutes for 
this action which have been attempted have failed. But I 
have left Dr. Formad's loftiest aspiration for the last para- 
graph. 



Original Communications. 315 

3. " He has found the tubercle bacilli of Koch, or, at 
least, bodies identical with them, in the sputa of non- 
phthisical patients." 

I will here take two things for granted: That the 
bodies (tubercle bacilli) so found are not true tubercle 
bacilli of Koch, but are identical with them. Now, the 
record don't say that Dr. Formad has spent a year or two 
cultivating these bacilli artificially, and having succeeded 
in doing so has made several hundred inoculations without 
causing phthisis. If this had been done the inference 
would be that these bodies were identical only in appear- 
ance with the tubercle bacilli. What a terrible bombshell 
this is to throw into the fort of experimental truth! All 
bacilli look alike, else they wouldn't be called by the same 
name. The distinctions l>etween Brocellus, Anthracis Bro- 
cellus, Anglobacfpr, B. Ulna, B. Ruber, B. Du Vin Tourme, B. 
De Infusions, and all others are identical, or nearly so, in 
appearance with B. Tuberculosis. 

The distinction between the bacilli is not a microscop- 
ical one but a physiological distinction. 

But science, in its relation to the mind, is something 
like a " grist mill.'' All phenomena most come beneath the 
"upper and nether millstone" in order to grind out the 
truth. If there were no '' nether millstone " the grinding 
would be a one-sided affair. The author of '"Unwashed 
Bacteria," therefore, bears a certain relation to science. 



Art. II.— Ovarian Irritation. By O. B. Will, M. D.. Dunlap, Peoria County, 
111. A Paper read before the Peoria City Medical Society, Nov. 21, 1882. 

According to my understanding, the term "ovarian 
irritation," implies the existence of a morbid state of an 
ovary, indicated by pathological manifestations of a more 
or less local and general character, independent of any 
gross anatomical lesion of the organ. Although such defi- 
nition may not be very clear, it is the most accurate that I 
am able from either observation or reading, to formulate. 
In so far as my familiarity with the literature of this sub- 
ject enables me to judge, it is one of the most obscure 
within the domain of medicine and surgery, and deserves 



516 The Peoria Medical Monthly. 

sl\ the attention which it can receive in the line of original 
research and observation. 

Dr. Emmet, in his work on the diseases of women, 
claims that ovarian irritation, independent of uterine 
disease, is very rare, and says. '* the ovaries are supplied 
with nerves from the renal plexus, but so scantily that in 
the absence of inflammation a doubt may arise as to the 
pain, which is so frequently experienced in their neighbor- 
hood, being due to 'ovarian irritation,' or whether even it 
has any direct connection with the ovaries." But there are 
those who ai^parently disagree w4th him, but whose state- 
ments, at the same time, seem to conflict with those of 
each other. Dr. Milner Fothergill, in a paper read before 
the Harveian Society of London, describes a condition 
which he denominates " ovarian dyspepsia," a gastric dis- 
turbance which is not primary, but reflex in character, from 
ovarian irritation ; a very intractable malady, accompanied 
by leucorrhoea and commonly with menorrhagia. The 
treatment found most efficacious being the use of potassium 
bromide, magnesia sulphate, and blisters over the region of 
the ovary. 

Under the head of " functional irritability of the 
ovary," Dr. Habershon, of Guy's Hospital, London, describes 
some cases of disease characterized by absence of local 
pain or soreness of any considerable degree, but exhibiting 
reflex disturbance of pneumogastric nerve and consequent 
vomiting; body not wasted materially, some food evidently 
retained, bowels geaerally confined, pulse irritable, abdo- 
men fairly distended. Other indications of nervous excite- 
ment. Sometimes aptly termed "hysterical stomach." 
Tonics with chalybeates often relieve, seldom cure. 

Di". Byford, of Chicago, in his recent revised work on 
the diseases of women, strongly insists upon a recognition 
of the fact that disturbance of the blood-making powers 
seems to be frequently prominently associated with pro- 
lapse of the ovary to a greater or less degree ; and Dr. 
Weir Mitchell, of Philadelphia, in his work on '' Some of 
the Nervous Diseases of Women," remarks on the frequent 
occurrence of grave nervous symptoms, aj^parently having 



Original Communications. 317 

their origin in some rather obscure morbid state or position 
of the ovaries. 

It seems to me fitting to thus give a brief resume of 
what has been said by some workers of prominence in re- 
lation to my subject, before giving my own exj)erieuce in 
the diagnosis and management of this peculiar malady 
which, whatever its exact pathology, is a recognized source 
of great evil, through its reflex influences, and in its thera- 
peutics thus far ill-defined and unsatisfactory. 

Within the past year or two I have had a larger pro- 
portion than common of cases of ovarian trouble, and have 
been led to observe with more than ordinary care the 
symptomatology of and influence of remedial agents upon 
them. In order that I may more connectedly state the 
results of such observation, I will give a brief history of 
my most nearly typical case of an obscure form of the 
malady, and group about it the distinguishing features of 
the others, in as few words as possible. 

One year and a half ago Mrs. K. consulted me in re- 
gard to a condition of ill health from which she had been 
suffering for about one month. She was 31 years of age, 
and had been married three months. Although of an im- 
pressible nervous temperament, she had previously been in 
good health and free from pain, except during her men- 
strual periods, which never lasted more than one or two 
days, when she would experience some ''queer" feelings in 
the stomach and chest, with an occasional lancinating pain 
in the right inguinal region. When I first saw her she 
was suffering from almost nightly attacks of severe cramp 
in the stomach, vomiting, with some degree of unconscious- 
ness and alarmingly difficult and stertorous breathing. 
Spasms would sometimes lend their aid in making night 
hideous, and the patient's struggles for breath would soon 
awaken her husband. Mustard plasters over stomach and 
back usually sufficed to restore consciousness and relieve 
severity of symptoms, and hot irons to restore warmth to 
the invariably icy cold feet. Upon closer examination I 
found the woman rather thin in flesh, somewhat pale and 
ansemic looking, tongue slightly coated, poor appetite, 
bowels constipated, urine high colored, but normal as to its 



318 The Peoria Medical Monthly. 

acidity and the existence of albumen; abdomen moderately 
distended, some cough, more or less irregularity of heart's 
action, pulse variable in quantity and quality. Headache 
was present almost constantly; backache, tenderness along 
the spine, and a general nervous excitability. Her men- 
strual periods were regular as to time, but lasted not more 
than one, or at most, two days. The flow was always 
scanty, dark in color, but never accompanied by pain other 
than an occasional sharp twinge in the region of the right 
ovary ; the latter being an almost daily occurence of late. 
No difficulty in urinating, no pain down the thighs. The 
severe attacks of cramp and dyspnoea invariably came on 
some time during the night, accompanied or preceded by a 
sort of nightmare. No pain excited by coition. 

I considered the case one of simple anaemia, with 
secondary neuralgic trouble, and treated it for a time with 
bitter tonics, iron, quinine, strychnia, phosphorus, good 
diet, sunshine and fresh air, but all to no purpose. I used 
subsequently counter-irritants to the spine, followed in 
time by the application of electricity in several of its 
forms, the positive electrode being passed along the spine 
and the negative over the chest and abdomen, but without 
any perceptible benefit. My patient finally very reason- 
ably concluded that I did not understand her case, and 
placed herself under the care of a neighboring practitioner 
of considerable repute. For a month or more I saw noth- 
ing of her, when she again cast herself under my care on 
an appeal for relief. Her latter physician had prescribed 
for her a mixture of iron and quinine, but after taking it 
for some time without benefit, she became disgusted and 
thought to leave off treatment altogether. Her distress 
compelled her to again seek medical aid. 

Before again treating her case I made an examination 
per vaginum; not because there seemed to be any special 
indication of disease in that locality, but to satisfy myself 
and patient that there positively was none. I found every- 
thing natural there, with the exception of what I consid- 
ered a slightly prolapsed and slightly enlarged right ovary, 
from which I could elicit only a very little pain by pressure 
between my fingers on the inside and hand on the outside, 



Original Communications. 319 

through the abdominal wall. 1 again adopted much the 
same treatment as before, with the addition of repeated fly 
blisters over the region of the ovar}^, and potassium bro- 
mide internally, but I had the mortification of still accom- 
plishing almost nothing towards my patient's relief. 

I continued to entertain the idea that the ovary was at 
fault, and came to the conclusion to test the influence of a 
strong faradic current passed directly through the sub- 
stance of that organ. 1 did so by placing the positive elec- 
trode sponge on the abdomen directly over the ovary, and 
a metallic vaginal electrode, one inch in diameter, into the 
vagina, pressing the ovary as firmly as possible between 
them. I used a strength of current represented in the 
fourth part of an ordinary Kidder " Tip " battery, without 
using the switch or drawing the cylinder. 1 continued the 
application for fifteen or twenty minutes, and after the 
second one, on the third day, the distressing symptoms of 
which the patient had complained for so long a time 
entirely disappeared and have not been experienced since 
— now these five months. At present writing the patient 
ha,s almost entirely regained her former good health and 
fee'Js that she will soon get rid of the doctor. Of course the 
appiUcations of electricity were persevered in for several 
mont;hs at lengthening intervals, and the use of wine, iron 
and c^xercise in the open air continued. 

T have, since my first experience in the above case, 
encountered several others of a similar character, which 
th6 limit set for this paper will not permit me to refer to 
fu rther than to say that the same treatment, in the main, 
sufficed for their cure. 

Now the question naturally arises, What was the exact 
pathological condition present in my cases benefited and 
'cured by the electricity? I do not know. But my expe- 
^ rience has taught me this : That there are practically three 
types or forms of " ovarian irritation," requiring each a dis- 
tinctive treatment. One is dependent for its causation 
upon uterine disorders of various kinds, and is cured only 
by their removal. Such fall under the almost daily obser- 
vation of every physician. Another is the direct result of 
either active or passive congestion of the ovary, from extra 



320 The Peoria Medical Monthly. 

uterine causes; and another, of which my detailed case is 
an example, is to me too obscure in its causation to war- 
rant me in venturing an opinion. 

Of what I have seen fit to place as the second type of 
" ovarian irritation " the symptoms are: Reflex disorders of 
various kinds, more or less constant and well-marked ten- 
derness in the ovarian region, with severe pain and in- 
creased tenderness just before and during the menstrual 
period, often, but not nearly always, accompanied with 
menorrhagia; pain in the back and aching through hips 
and thigh. Sometimes the ovary can be detected in mal- 
position and is always quite sensitive to pressure in its im- 
mediate vicinity. This, I think I am safe in saying, is the 
form in which the bromides, salines and blisters have been, 
found most effective. It is the form of the complaint in 
which I always use those remedies, counseling absolute 
rest for some time before and during the menstrual flow. 
In this class of cases I have found the use of the electric 
current to do not only no good but, seemingly, positive 
harm. However, in the last class of cases, characterized 
by all the reflex phenomena which we find in every fo^m 
of ovarian irritation, with absence of soreness, but presence 
of acute lancinating pain in the region of the ovary, and 
possibly enlargement and prolapsus, the faradic current is 
the remedy par excellence, and, judging from my own expe- 
rience, will never disappoint. 



Akt. III. — Some Forms of Sexual Neurosis. By Thos. H. Line, M. D., A.de- 
line, 111. 

The observations of a certain class of cases, by no 
means infrequent, may be of interest to some of your 
readers. They are cases of which, perhaps, no two will be 
found alike, and yet there is such a general likeness as will 
show the family traits. For lack of a more fitting name 
we will take that of another, namely. Sexual Neurosis, 
which is sufficiently expressive. As I have said, the symp- 
toms of each patient are so peculiarly individual that it is 
almost impossible to define any group of symptoms, which 
are constant, so I will try and describe a few cases in brief 
as they have been presented to me. A young man comes 



Original Communications. 321 

to the office in a bashful sort of a way and states that there 
is something the matter with his sexual organs, and his de- 
scription of the case is so vague that at first you are led to 
suspect some form of venereal disease. But no; he has 
never indulged in sexual intercourse, and it is onlj' by 
sharj) questioning that you finally learn that he. ''like 
other boys," has masturbated to a greater or less extent, 
and usually, when the confession gets this far, he thinks 
himself a very great sinner. But after all, perhaps, when 
you have come to narrow the matter down, he has only ill- 
defined sensations of discomfort with not even the usual 
penalty of excessive masturbation, namely, some extent of 
spermatorrhoea. Some of the cases have a degree of pros- 
tatorrhcea, as shown by the sticky mucus at the mouth of the 
urethra after they urinate, which is undoubtedly a small 
quantity of the* prostatic secretions thrown off by the 
pressure brought to bear in the act of arination. But then^ 
unfortunately, your patient has been thoroughly posted in 
the best literature of the day, and answers you that his 
semen is being discharged backward into the bladder and 
is now passing off with his water. A bad state of things; 
the books will tell you so. iVnd, again, he coolly tells you 
that if you are not sure that you can cure him probably he 
would better go to the city, where, he understands, there 
are men who make this trouble a "specialty." Another 
shade of trouble of these young men is that they are 
gradually becoming impotent as a penalty for their mis- 
deeds. They have no particular reason to fear, they have 
erections, but still they have a fear that there is some 
feebleness of virile power. Some express a great deal of 
anxiety for fear they might wish to marry, and if they do 
'whether they would be able to perform the duties expected 
of them in such relation. Young, healthy and vigorous 
looking married men will come to you sometimes com- 
plaining that their capacity for the sexual act is incomplete 
and unsatisfactory, when, if you will put them on an ex- 
pectant plan of treatment, and direct a system of hygienic 
measures, of which fasting, sexually, is the important ele- 
ment, you will learn in time that the young bride is about 
to become a mother. Doubtless, with a very large propor- 



322 The Peoria Medical Monthly. 

tion of these cases, any pathological condition, and also 
the real necessity for medical treatment, is wanting. 
Nevertheless, I am sure there is a perverted condition of 
the nervous system in nearly all of these cases that is of 
much importance — a state akin to the disturbed condi- 
tions to which we give the name hysteria. 

In addition to these ill-defined cases, I think we have 
belonging to the same general class of sexual neurotic 
patients, the various degrees and manifestations of sper- 
matorrhoia; or, as Curschniann expresses it, "abnormal 
seminal losses.'' According to Curschmann almost every 
adult male, during the years of sexual activity, loses, from 
time to time, a certain quantity of semen at night during 
sleep, generally with erotic dreams, accompanied by erec- 
tions and special sensations, unless the seminal evacuation 
be caused by coitus or other mechanical. cj^use. This kind 
of loss is called a piAhition. They, of course, occur most 
frequently during the years of greatest sexual activity; but 
their first appearance varies in difi'erent persons, according 
to their mental and bodily conditions, such as training, 
temperament, mode of life and direction of thought. The 
same circumstances determine the frequency of the pollu- 
tion, which occur in some persons once a week or oftener; 
in others once a month or less frequently. They have no 
regularity in the same person, but vary according to tem- 
porary causes. " Usually," says Curschmann, " the day 
after the seminal losses there is a feeling of relief and 
brightness; or, at any rate, an absence of any subjective or 
objective suflering." It is a mistake to try to decide 
whether they are healthful or not, for wdiat will be injuri- 
ous to one man, and require medical intervention, may be 
a healthy condition in another. 

The late Dr. Bumstead once wrote a paper on sperma- 
torrhoea which contained, in a brief space, as much good, 
sound sense as is often met with. He places more reliance 
on hygienic measures than drugs. And, particularly, he 
gives but little importance to the popular and accepted 
theory of masturbation being the cause of nocturnal semi- 
nal losses. Furthermore, he regards occasional losses of 
this kind, as frequent as once in a fortnight, or less even, 



Original Communications. 323 

as normal. Hence the statement will not create surprise 
that in ninetj^-nine out of one hundred cases these emis- 
sions require no medical or surgical treatment. The chief 
danger from them lies in the patient making himself 
miserable over them. If he can be induced to give his 
mind and body to pure thoughts and healthy exercise, 
nature will take care of the rest. Still, he does find certain 
indications for medication; and, indeed, a few of these 
cases could be detained long upon a strict hygienic system. 
Then he employs bromide of potash and strychnia to con- 
trol the frequency of the emissions, and iron, or iron and 
strychnia, to meet the conditions of anaemia and imperfect 
nerve nutrition. To this you can add fluid extract of bella- 
donna, and you will convert what is generally considered a 
grave manifestation into a form not uncommon in healthy 
men and not requiring interference. 



Art. IV.— Labor Delayed by Retained Placenta. By Geo. B. Parsons, 
Hooper, Nebraska. 

On the 19th inst., at 10 o'clock p. m., I was called to see 

Mrs. C , a primipara aged 31, strong and well developed. 

Labor had commenced at an earl}- hour in the morning. I 
at once made a digital examination and found a pelvis of 
ample dimensions, soft parts in good condition, the amni- 
otic sac ruptured, presentation normal, with head not large 
and just entering the lower strait; pains frequent, regular 
and of moderate force. Contrary to the usual habits of 
the primiparag of mature age, I predicted an almost imme- 
diate deliveiy. Why not? Notwithstanding all these 
favorable conditions, labor continued with no intermission 
of pains, save only about one hour, for over forty hours, 
ivltli little or no progress. The patient, while showing great 
courage, began, together with friends and attendants, to 
lose confidence, if not in my skill in iny predictions. The 
woman was not failing in strength, but I could not find the 
cause of delay and could see no prospect of nature being 
able to overcome it, and therefore decided to apply the for- 
ceps, ihis decision caused a scattering of friends and at- 
tendants, who fled in tears to other parts of the house and 



324 The Peoria Medical Monthly. 

even out of doors, because of having witnessed a butcher- 
ing job of instrumentation in the case of a neighbor lady 
not long before. I applied the long forceps without much 
difficulty, and at first failed, after making strong traction 
to deliver, but after a short rest made another effort, when 
something gave way and a six-pound child was easily de- 
livered. As soon as the head was delivered the cause of 
the trouble began to be apparent — two turns of the cord 
were around the neck. The child was asphyxiated, but 
was easily restored. After attending to the child I intro- 
duced the hand and found just below the fundus, on the 
right side, the upper half of the placenta had been torn 
off. leaving shreds of secundines and the lower half still 
adherent. Thus the whole mystery was cleared up. Dur- 
ing the last twelve hours the patient had complained of 
pain and soreness, and a hard lump was to be felt where 
the placenta was attached, which the attendants were cer- 
tain was a* second foetus. 



0^0nt$i)Ott(lcna. 



Good Eflfects of Ergot. 

Gaylord, Minn., Dec. 4, 1S82. 
■Editor Peoria Medical Monihly : 

Mrs. L. Winthrop, Miun., was taken in labor at 11 p. m., 
August 23, 1SS2, with a midwife in attendance. At about 
noon the 24th Dr. Lilly, of Winthrop, was called in. He 
and the midwife worked faithfully with the lady till S p. m., 
when they dispatched for me to come on the first train. I 
arrived there at 11 p. m. The lady had then been in labor 
for twenty-four hours. Upon examination, I found position 
normal, with no obstruction in maternal passages; the os 
well dilated, and had been so for the last twelve hours; 
patient very much reduced, and uterine contractions insuffi- 
cient. The doctor stated he had given her no medicine of 
any kind. Being, as we were, without any forceps I con- 
cluded to put her on ergot. Within an hour after the first 
dose the pains became more periodical and forcible, and at 
the end of two hours 1 delivered her of a fine male child. 



COREESPONDENCE. 325 

Both did well. I know we are taught by some to never 
give ergot in oases of prolonged labor; but I thought it was 
indicated in this case, under the circumstances. She was 
a primapara. 

Case seco;?fZ.— November 20 I was called to Mrs. B., who 
had been in labor for twenty-four hours, with a midwife in. 
attendance. Upon examination, found position and pas- 
sage normal, but insufficient uterine contraction. Gave 
patient a half drachm of ergot, and pains soon came on 
naturally, and I delivered an hour later. 

These two parties have learned by bitter experience 
that midwives are a nuisance. 

D. N. Jones, M. D. 



Delivery of a Five-Montlis' Foetus Enclosed in the Amniotic Sac* 

Lincoln, 111., Nov. 19, 1882. 
Editor Peoria Medical MontltJij: 

In the month of August last I was called to visit Mrs. 
H., in her fifth labor. Her pains being severe I immedi- 
ately, upon my arrival, made an examination and found 
the amniotic sac containing the foetus and placenta with at 
large amount of liquor amnii protruding through the vulva- 
One or two more pains and the entire contents were ex:-- 
pelled. No hemorrhage followed. 

L. L. Leeds, M. D. 



Tlie Screw Worm. 

Oswego. Kansas, Nov. 25, 1882. 
Editor Medical Monthly: 

Dear Sir : Very few of your readers, perhaps, ever 
heard of the screw worm, a pest we had to contend with 
here last season in man and animals. The screw worm is 
the larvae of a dipterous insect or hexapod, a native of the 
regions south of here, particularly Texas, where it is the 
death and torment of animals, particularly dogs and sheep. 
I do not know the generic or specific name of the dipter — 
the books in my possession on entomology do not describe 
it. The musca ceazar is a similar insect described by 



326 The Peoria Medical Monthly. 

Packanl. The insect blows or lays its ovum or young on 
a wound, and when it incubates the larvae or maggot eats 
its way rapidly into the animal and causes its death. 
Neglected infants are afflicted with the pest, and drunken 
and other persons sleeping in the open air of summer days 
are "Hy blown" in the nostrils, and the insect works its 
way into the head, causing a horrible death. A i^reacher 
at Cherry Vale, west of here, was destroyed in this way. 
Before he died the maggots came from his head, no doubt 
to pupate. 

A friend wrote me last week that a man named Carter 
was very ill, twenty miles east of here, last fall. He had 
spasms and his life was despaired of a longtime, but finally 
about a hundred maggots came from his nostrils and he 
recovered. 

Old King Herod, we read, was eaten with worms and 
he died — no doubt the same dipterous larvae. To destroy 
the pest stockmen and others use calomel and carbolic acid. 
The first may be blown into the nostrils of a person 
afflicted wdth screw worm. 

The dysentery that prevails here I have frequently ar- 
rested and benefited with persulphate of iron. Some cases 
where other astringents utterly failed, this agent acted as 
well as could be desired and saved life. 

For coughs and colds I am using two news remedies, 
discovered by myself — the elephantopus and helianthella. 
Frequently they may be combined with other medicines to 
advantage. Messrs. P. D. & Co. sell an extract of both of 
these composites. 

Itch rubeola and diphtheria are mild diseases where I 
write. The germs causing them being organic, live in the 
same frigid and thermal lines on the earth as do the ele- 
phant and other animals and plants. Scarletina has been 
also an unfrequent malady here, and mild, I think, com- 
pared with it in Illinois and north. 

I am your friend, 

W. S. Newton, M. D. 



Periscope. 327 

Coimter-Irritatiou. 

Of all therapeutic measures there is probably no single 
one so universal, and so potent in its application, as coun- 
ter irritation. The disputed point, as to whether it pro- 
duces its results through the agency of the nervous or the 
circulatory S5^stem, has no practical interest for the busy 
physician. He has but little time for theories or physio- 
logical experimentation. What he most desires are facts 
and results. In counter-irritation he has them both; it 
can cure, and it does cure. It matters but little in kind, 
but greatly in degree, what counter-irritant is used. When 
we desire a profound impression, as in the initial stage of 
sthenic pleurisy, nothing short of a fly blister, and a big 
one at that — one that will cover the wdiole affected side — 
will do any good. A mustard plaster, under such circum- 
stances, will be like a child playing at w^ar as compared 
with real battle. Whereas, wdien we meet an asthenic 
type of the same disease in a weaklj^ and debilitated indi- 
vidual, the violent fly blister would be too powerful and 
resort must be had to the gentler mustard. Much unde- 
served odium has been cast upon counter-irritation, as upon 
many other therapeutic measures, because of inferiority in 
quality of the article used. We have used half an ounce 
of cantharidal collodion with the result of merely soiling 
the part to which it was applied; it did not even redden the 
skin, while half a drachm of a good article, applied to the 
same part, on the same person, blistered most terribly. 

Many object to counter-irritation of a severe character 
on the ground that it produces an external sore that is 
sometimes very hard to heal. That this is true no one can 
doubt. It does sometimes happen that very tedious and 
painful abrasions of the skin, or sores, do result from fly 
blisters or tincture of iodine, or some other equally power- 
ful counter-irritant. But these are exceptions, and ought 
not to militate against the rule, which is, that this form of 
treatment is an exceedingly valuable one in nearly all 
affections of an inflammatory nature. A large volume 
could be written on the counter-irritants and the great 
value of counter-irritation, but it is not our purpose to do 
more than merely call your attention to the matter. Every 
physician . must wisely judge what cases are suitable for 
this form of treatment, and what articles are appropriate 
to the effect desired. But remember that, while it will be 
all very well to resort to internal medication, counter-irri- 



328 The Peoria Medical Monthly. 

tation can do no serious harm, and it will oftentimes amaz- 
ingly aid the action of your drugs. — Medical and Surgical 
Beporfer. 

Treatuieut for TapcAvorm. 

The writer has for many years past received occasional 
letters of inquiry as to what is the best drug for the expul- 
sion of tapeworm, and the inquiry is generally accompanied 
b}^ the statement that a case is under treatment that has 
resisted all the ordinary parasiticides, such as pumpkin 
seed, male fern, kooso, bark of pomegranate root, turpen- 
tine, etc. As any one of these drugs are sufficient, under 
any good ordinary management, to expel the parasite, and 
as the inquirers had generally succeeded in most of their 
cases with some one or other of these medicines, it has 
generally been concluded that it was not Si question of the 
choice of a drug in the obstinate cases, but rather one of 
the location of the attachment of the head of the worm in 
the intestinal canal. 

When the writer served as demonstrator of anatomy 
many years ago, he observed that there was great variation 
in the location of the head. Sometimes it would be found 
attached up near the duodenum, and at other times down 
near the ileo-c(Pcal valve, and that the attachment was not 
unfrequently in a little pouch, or under a fold of mucous 
membrane; and that the head was always imbedded in a 
nidus ot firm jelly-like substance, like inspissated mucus. 
This led to the conclusion that such cases would be very 
differently aft'ected by treatment, and that a method quite 
efficient for some cases would be likely to fail in others 
from the difference of location, and further, that the obsti- 
nate cases were those where the attachment was so low 
down in the canal and so iDi'otected that it was difficult to 
get the parasiticide in contact with the head so as to poison 
it, and cause it to let go its hold. A few years later when 
in the eastern part of the Mediterranean, where uncooked 
sausages are largly eaten, the writer and others became 
aftected with tapeworm, and he had good opportunities for 
observation, and was confirmed in the belief that the loca- 
tion of the head had much to do with the resistance of all 
obstinate cases, and that when the treatment was carefully 
directed by this consideration it was almost always suc- 
cessful, and that one parasiticide was about as good as 
another when well managed. Further experience at that 
time seemed to show that pumpkin seed and and oleoresin 
of male fern were the best agents to use, and there was 
but little choice between them. A plan of treatment was 



Periscope. 329 

adopted which has been since given to so many physicians 
and patients with such general success that it may be worth 
while to publish it. 

After a light dinner, near the middle of the day, the 
patient should take no food, but may drink freely of water. 
At bed-time a saline aperient should be taken in effective 
dose, and there is nothing l^etter than one or two Seidlitz 
powders. This aperient should be saline, because these 
cause a copious effusion of serous liquid from the whole 
mucous membrane of the canal, and this effusion taking 
place from the surface where the head of the worm lies 
jjrotected by the dense mucus, detaches the mucus and 
washes it away, leaving the head bare for contact with the 
parasiticide, when otherwise it would pass over it without 
direct contact, and therefore, without" effect. 

Whether this aperient at bed-time operates at night or 
not, it should be repeated on the following morning, the 
patient still abstaining from food. After the second saline 
has operated freely, or say at about ten o'clock, the medi- 
cine should be given. 

Four ounces of pumpkin seeds are well l^eaten in a 
mortar, half an ounce at a time, a few drops of water being 
added from time to time until they are made into a paste. 
The shells need not be rejected, as they are rather useful 
than hurtful. A¥ater is then gradually added to the paste 
with trituration, until a tolerably uniform emulsion is 
made measuring about a pint. This may be flavored if 
desired and iced, and is to be given in three doses at inter- 
vals of about two hours, beginning at about ten o'clock. 
During this time the patient should lie quietly in bed and 
avoid all causes of nausea and vomiting, and should cor- 
rect these if they occur by a little ice being taken into 
the mouth and stomach. The stomach in need of food will 
often digest the first dose, but a tendency to nausea will 
prevent the digestion of the others, and the third is often 
difficult to take without vomiting. By careful manage- 
ment and quiet the inverted peristaltic action may be 
generally avoided. But when it occurs earh^ and persis- 
tent the treatment is likely to fail, because the inverted 
action of the bowel prevents the emulsion from getting far 
enough down to come in contact with the head of the 
worm. Commonly, however, the peristaltic action will not 
be reversed, and at about the time of the third dose or a 
little later there will be an alvine evacuation. But if within 
an hour after the last dose, a half fluid ounce of castor oil 
should be given in a little ale or porter. The evacuations 
should be received in a vessel partly filled with water so 



330 The Peoeia Medical Monthly. 

that the worm can be easily examined from end to end of 
each i^ortion without breaking, and when the part is 
reached where the links grow smaller great care should be 
taken to find the head, for unless this be found the success 
of the treatment is by no means assured. And if the head 
be not found, detached links may be expected in the stools 
within two or three months, and the treatment will need 
to be repeated with larger preliminary fasting and greater 
care. 

In a second trial, or when persistent vomiting has in- 
terfered with the first to invalidate it, the oleoresin of 
male fern may be substituted for the pumpkin seed. This 
is more easily taken than the large doses of the emulsion, 
and is not so easily digested by the stomach, nor so liable 
to produce nausea, and from being an oleoresin, and there- 
fore less soluble in the liquids it is with, it is more likely 
to reach the head of the worm in a condition sufficiently 
concentrated to be a jDoison to the head, but it is probably 
a less active poison to the head than the pumpkin seed. 

The oleoresin may be given in emulsion made with sugar 
and gum arable, or with glycogen, but is perhaps better 
given in capsules, containing about ten grains each. Two 
of these should be taken every quarter of an hour until 
twelve capsules have been taken, unless nausea occurs of 
sufficient severity to endanger their rejection. Under such 
circumstances eight or ten capsules may be used as being 
all that can be safely given. 

The oleoresin has often, especially in cold weather and 
when of good quality, a thick granular sediment. This 
should be carefully stird in before weighing, as it is a very 
important part of the drug. 

Of course the same careful preparation of the patient 
is needed with this as with the pumpkin seed, and neither 
of them should be expected to succeed in obstinate cases 
without the careful preliminary treatment. — Squibb' s 
Ephemeris. 

How to Make a Poultice. 

At first sight the title of this paper may seem absurd 
to many of our readers, and the idea that medical men re- 
quire any instruction in making a poultice preposterous, 
but we have been led to write it from seeing that many 
students and some practitioners do not distinguish between 
the proper methods of making a poultice for surgical and 
for medical use. Many, perhaps most, students spend a 
great part of their four years* curriculum in surgical study, 
and devote a comparativeh^ small portion of it to medicine. 



Periscope. 331 

This may partly be the reason why they do not learn the 
best waj^s of making poaltices for the relief of internal 
pain ; but another reason is. that in hospitals poultices are 
made in certain ways for the sake of cleanliness and 
economy, and these ways are not always the best possible 
for private patients, although they may l^e the best under 
the conditions which obtain in hospitals. Everyone knows 
the relief which a poultice aifords when the finger is in- 
flamed, and has noticed how the painful throbbing dimin- 
ishes after its application. Most people have noticed also, 
that dipping the finger in cold water has a similar action, 
and it seems strange to many that the opposite conditions 
of heat and cold should have a similar eftect. The reason 
probably is that both heat and cold lessen the force of the 
impulse with which the blood is driven through the dilated 
arteries of the inflamed parts against the block which ex- 
ists in the capillaries. Cold causes the afferent arteries to 
contract, and lessens the impact of the blood by diminish- 
ing the quantity sent to the inflamed part : a poultice les- 
sens the impact by dilating the capillaries surrounding the 
seat of inflammation and aflording a ready side outlet into 
the veins. In surgical cases we usually use the warmth 
and moisture of the poultice to act directly on the surface. 
We therefore make the poultice with crushed linseed or 
with linseed meal and oil, spread it on some tow and apply 
it to the skin without anything intervening. But useful 
though this method may be for wounds, ulcers and ab- 
scesses, it is not the best form of application in cases of 
inflammation of the thoracic or abdominal viscera, or 
where spasm is present without inflammation. In such 
cases we may, no doubt, do some good by applying the 
poultice to the surface exactly as in surgical diseases. We 
may draw off some of the blood to the surface; and we may 
also exercise a reflex action through the nerves upon the 
vessels of the inflamed organ below, but this will not be so 
great if we influence the surface only, as when we allow 
the heat to penetrate to the inflamed or irritated organs 
themselves. If we apply the poultice directly to the skin, 
•it must be allowed to become tolerably cool before the pa- 
tient can bear it, and thus half its advantage is lost. In 
order to relieve spasm, as in colic — intestinal, biliary, or 
renal; to relieve inflammation of the pleuro, the lungs, the 
liver, or other organs, we want to apply the poultice as hot 
as possible, while we protect the skin from being scalded. 
In order to do this, a flannel bag should l)e prepared, a con- 
venient size being 12 inches by 8; this should be closed at 
three edges and open at the fou]-th; one side of it should be 



332 The Peoria Medical Monthly. 

about one inch or one inch and a half longer than the 
other, and it is convenient also to have four tapes attached 
at the points which form the corners when the bag is closed, 
in order to keep the poultice in position. Besides this, an- 
other strip of flannel should be prepared of the same 
breadth as the length of the bag, and long enough to wrap 
round it once or oftener. Crushed linseed, bowl and spoon 
should then be got together, and the spoon and bowl thor- 
oughly heated by means of boiling water; the poultice 
should then be made with perfectly boiling water, and 
rather soft. As soon as it is ready it should be poured into 
the bag. previously warmed ])y holding it before the fire. 
The Hap, which is formed by the longest side of the bag, 
should now be turned down and fastened in its place by a 
few long stitches with a needle and thread. It should then 
be quickly wrapped in the strip of flannel (also previously 
warmed), and fastened in situ, if necessary, by means of 
the tapes. It ma}^ be covered outside with a sheet of cot- 
ton wool. In this way the poultice may be applied boiling 
hot to the skin without l3urning. The two layers of flan- 
nel, which are at first dry, allow the heat to pass very 
gradually indeed to the skin. As the moisture of the poul- 
tice soaks through them, they become better conductors, 
and the heat passes more quickly, but the increase is so 
gradual as not to cause any painful sensations whatever, 
but only one of soothing and comfort. The poultice, also, 
naturally keeps much longer hot. and the necessity for 
changing it arises much less frequently. The difference 
between the effect of a poultice made in the ordinary way 
and in the manner just described, is sometimes exceedingly 
striking. It is, perhaps, less marked in cases of inflamma- 
tion than in those of spasm. We have seen a patient 
suffering from intense abdominal pain at once relieved by 
a poultice made in the w^ay just described, although a suc- 
cession of poultices made in the ordinary way had been 
utterly useless. This way of making poultices is one of 
the minutige of medical practice ; apparently extremely 
trivial, but really, w^e believe, very important. The relief 
which we have seen afforded by poultices made in this way, 
and the knowledge that some practitioners at least are ig- 
norant of the method, must be our apology for drawing 
attention to such a trivial detail. — Practitioner. 



Treatment of Ob.stinate A'^omiting-. 

In the course of an article on this subject in the Boston 
Medical and Surgical Journal, Dr. S. CI. Webber says: Often 
the best method of treating this complication is to give the 



Periscope. 33B 

stomach rest. Sometimes only a laTge amount of food 
taken at one time excites vomiting; then it is sufficient to 
resort to frequent feeding, giying a verj" small quantity 
each time, a mouthful or a spoonful every fifteen or thirty 
minutes: thus the stomach never contains a large mass of 
food requiring considerable muscular exertion to roll it 
about, and by its weight or bulk exciting the reflex irrita- 
bility of the nerve centers. Many times, however, this is 
not enough; the stomach requires more complete rest, and 
the best treatment is to withhold all food and medicine; 
sometimes a few hours" rest is enough, again it requires 
two or three days; then it will be necessary to use nutrient 
enemata. Where there has been much vomiting thirst 
may be very annoying to the patient; small lumps of ice 
held in the mouth will relieve this, and generally does not 
cause vomiting. After the stomach has had sufficient rest 
it is best to commence feeding by the mouth, with caution, 
giving a little frequently. Milk and lime water, equal 
parts, a teaspoonful every half-hour, should be first tried; 
if well borne the amount can be increased gradually. It is 
a mistake to increase the quantity too rapidly, — Medical 
and Surgical Bejjorfer. 



Tlie Treatiueut of Eiupyeiua. 

In an article on the above subject {American Journal 
Medical Sciences, Oct,. 1SS2) Dr, W. C, Dabney sums up the 
following conclusions: 

1. "Medical " treatment, as it has been called, namely, 
treatment without operation, occasionally gives favorable 
results, but is not advisable, inasmuch as cases so treated 
are liable to terminate in one or other of the following 
ways: {a) Sudden death. (Ij) exhaustion, (c) suffi^catiou, (/i) 
phthisis, [e) septic£emia. (/) calcareous degeneration of the 
pus, {(/) secondarj^ pneumonia and gangrene of the lung, 
{h) peritonitis from the bursting of the empyema into the 
peritoneal cavit}^ (/) amyloid degeneration of the liver, 
kidneys, etc. 

2. Aspiration has given good results in the case of 
children, and should be tried in them before the radical 
operation is resorted to. 

3. Free incision into the pleural cavity is usually 
necessary, and the best point for such an incision, when 
only one is made, is at the lowest point of the purulent 
collection, and directly below the angle of the scapula. 
Costal resection is to be avoided, if possible, especially in 
children. 

4. Continuous is preferable to intermittent drainage, 



334 The Peoria Medical Monthly. 

because (a) the danger of absorption is thereby lessened, (b) 
there is usually less danger of irritative fever, (c) the 
empyeraic cavity is placed in a better position for healing. 
Continuous drainage is best effected l)y a drainage tube. 

5. Through drainage is only advisal^le in cases where 
the discharge is very fetid, and where a single opening has 
proved insufficient. 

6. The thoratic opening should not be allowed to 
close if more than two drachms of pus are discharged daily. 

7. The danger of sudden death during thoracentesis 
or injection of the pleural cavity, when proper care is used, 
is so slight that it may practically be disregarded; but 
when injections are used, especial care should be taken to 
see that they have a free outflow. 

8. Simple injections of pure water are often sufficient, 
but compound tincture of iodine, one part to four of water, 
is devoid of danger and hastens recovery. This will usually 
check fetor also; but if it does not, salicylic acid or per- 
manganate of potash in one-half or one per cent solutions 
may be employed. Carbolic acid is dangerous, as is boracic 
acid also. 

9. Listerism would probably be advisable in city or 
hospital practice, but is of doubtful efficacy in the country, 
and under no circumstances should it be allowed to inter- 
fere with through drainage. 



Infantile Couviilsions. 



The adopted and regular treatment of M. Jules Simon, 
of the Hospital des Enfantes Malades, for infantile convul- 
sions, is as follows: On arrival the first thing he orders is 
an injection of salt and water, salad oil, or glycerine, or 
honey, which he administers himself, as he has too often 
observed that the parents or the nurse have already lost 
their wits. If the teeth can be opened sufficiently a vom- 
itive is given which clears the stomach of any food that 
could not be digested — the most frequent cause of convul- 
sions. However, the attack continues, but soon ceases on 
applying a handkerchief on which a few^ drops of chloro- 
form are poured, to the mouth, which the child inhales 
largely. If convulsions reappear the anesthetic is renewed, 
and the child is placed in a mustard bath for a few minutes 
and then wiped dry and placed on his bed properly 
wrapped. Chloroform might be again administered if, 
after an interval, the child was seized again, and before 
leaving the nurse M. Simon prescribes a four ounce potion 
containing sixteen grains of bromide of potassium, one 



Periscope. ■ 335 

grain of musk, and a proportional preparation of opium, 
for he does not believe that the brain is congested in these 
attacks; it is rather excited, and the opium acts as a seda- 
tive. A teaspoonful of the mixture is given several times 
a day. On the following days the child is generally rest- 
less and irritable and ready to be attacked again, but a 
small blister about an inch square is applied to the back of 
the neck and left on about three hours, when it is replaced 
by a poultice of linseed meal and gives ji-ost satisfactory 
results. M. Simon, in terminating, says: "Such is the 
treatment that I have instituted in my practice every 
dav." — Medical Press and (Circular. 



A Xevv Test for Albiiiiien in the Urine. 

When an albuminous urine is treated with a saturated 
solution of common salt, not the slightest reaction takes 
place ; but if the brine be slightly acidulated with hydro- 
chloric acid, according to Dr.'Wm. Roberts, the albumen is 
thrown down as a dense white cloud. This reaction con- 
stitutes a most delicate test for albumen in the urine. The 
best degree of acidulation for this purpose is obtained with 
about 5 per cent, of the dilute hydrochloric acid of the 
Pharmacopoeia. A little more or less acid makes no ap- 
preciable difterence in the sensitiveness of the test. Com- 
mon salt dissolves in about two and a half times its weight 
of water at 60 degrees Fahrenheit, and an increase of tem- 
perature does not sensibly increase its solubility. The salt 
of commerce is always more or less dirty, and the solution 
requires filtration to fit it for use as a test. The salt solu- 
tion should be fully saturated, otherwise the observer is 
apt to be led into error. In preparing the test with our 
common English measure, the readiest plan is to mix a fluid 
ounce of dilute hydrochloric acid with a pint of water, and 
to saturate this with common salt and filter. Dilute hydro- 
chloric acid may be replaced by dilute sulphuric, dilute 
nitric, or dilute phosphoric acid. k\\ these acids are of 
the same saturating strength in the British Pharmacopoeia, 
and all of them yield with saturated salt solution an equally 
sensitive reagent for albumen. Even acetic acid may be 
used, but the delicacy of the test in that case is not quite 
so great as when it is prepared with one of the mineral 
acids. The method of applying the briny test is similar to 
that followed with nitric acid. A portion of the suspected 
urine is placed in a test-tube, the test-tube is then held 
very much aslant, and the salt solution is allowed to trickle 



336 The Peoria Medical Monthly. 

along the sides of the tube to the bottom, so that it may 
form a distinct layer below the urine. If albumen be 
present, a white cloudy zone appears at the junction of the 
two fluids. Or the proceeding may be reversed. The salt 
solution maybe first introduced into the test-tube, and then 
the urine, added with the same precautions as l)efore. so as 
to obtain two distinct laj^ers, one above the other, in the 
test-tube. It is important to be aware that the precipi- 
tation of albumen by acidulated In-ine is not due to a true 
coagulation. In this respect the brine test differs from 
nitric acid and boiling. In the two latter cases the albu- 
men is transformed into the insoluble modification, which 
is known as " coagulated albumen." But when albumen 
is thrown down from urine by acidulated brine, the precipi- 
tate is not insoluble; on the contraiy. it is redissolved by 
free addition of water, or even l)y free addition of the al- 
buminous urine itself. It is therefore essential to the 
efficient application of the test that the salt solution should 
be in excess at the point of expected reaction. This end is 
obviously secured in the above described methods of test- 
ing. In point of delicacy the salt test stands on a par with 
nitric acid. The minutest trace of albumen detectable in 
the urine by nitric acid is also detectable with equal ease 
by acidulated brine. In high-colored urine the brine test 
is distinctly superior. — Lanccf, Oct. 14. 18S2. — Med. Neus. 



Antipyretic Medicines --Their Action and Uses. 

Prof. Binz (London Medical Becord. June 15, '82.) says' 

1. In the present state of our knowledge, there are 
two modes in which antipyretic remedies may be conceived 
to operate: First, by increasing the discharge of the pyrex- 
ial heat; secondly, by checking its production. 

2. The quantity of heat discharged may be aug- 
mented by direct withdrawal (tepid water), or by facilitat- 
ing the circulation through the skin (digitalis, cutaneous 
irritants.) 

3. The production of heat may be lessened by re- 
peated cooling of the surface, and especially by the internal 
use of antizymotics. 

4. Febrile diseases commonly owe their origin to the 
introduction and rapid development of substances akin to 
ferments. Several of these have been shown to resemble 
yeast in being low vegetal^le organisms, or derived from 
such organisms. They enter the glands, where they un- 
dergo multiplication, increase the metabolic processes, 
generate products of decomposition which exert a par- 



Periscope. 337 

alyzing action on the nervous system, and raise the standard 
of temperature throughout the body. 

5. Owing to impaired action of the heart in certain 
stages of the disorder, or to contraction of the cutaneous 
vessels, the skin becomes ansemic, and gives off less heat 
than usual. The internal temperature rises accordingly. 

6. Quinine, our chief antipyrectic, acts by directly 
combating the efficient cause of the disorder, and by check- 
ing the abnormal metabolism going on in the body. The- 
nervous system takes no part, or only a secondary part in 
the operation. In intermittent fever, quinine prevents the 
paroxyisms by attacking the infective cause. The parox- 
ysms are not the essence — the substantive element — of the 
disease; they are only a symptom of it. The substantive 
element is the poison deposited in the colorless corpuscles 
of many organs, especially the spleen. There are fevers 
w^ith paroxysms that are the most malignant. The malar- 
ial poison rapidly causes disintegration of the tissues and 
the blood, and so paralyzes the nerve centers. 

7. The reduction of acute splenic tumors by quinine 
depends upon the adverse influence exerted by the alkaloid 
on the infective poison to which the morbid over-action ot 
the spleen and its consequent enlargement are due. "Cfs- 
sant causa^ cessat effecttisJ^ Even the healthy spleen maybe- 
reduced in size by large doses of quinine; the alkaloid- 
vigorously checking the oxidation of its principal elements, 
the colorless corpuscles. Quinine has no direct influence- 
on the vaso-motor nerves. 

8. Quinine attacks the malarial poison with especial 
energy; on this fact depends the so-called speciflc action 
of quinine in intermittent fevers. The same relation, but 
in a minor degree, subsists between quinine and the infec- 
tive poison of enteric fever, between mercury and iodine 
and the poison of syphilis, between salicylic acid and 
"irritant" in acute articular rheumatism. 

9. An antipyretic which, in one disease, instan- 
taneously arrests the fever, may be wholly powerless in 
another. The difference depends on the fact that the 
various antizymotics act very unequally on the invidual 
schizomycets and ferments; one will paralyze them rapidly, 
by another they will hardly be affected. 

10. The past history of therapeutics, and recent 
achievements in the domain of etiology and pharmacology 
entitle us to assume that, by persistent scientific inquiry 
and practical observation, we may succeed in discovering a 
speciflc antidote for every species of infective of septicsemic- 
malady. — Missouri Valley Med. Monthly. 



^38 The Peoria Medical Monthly. 

Some of the Relations of 3Ieteorologieal Phenomena to >Ian. 

We condense from the able address of Dr. Tripe. Presi- 
dent of the Society of Medical Officers of Health, published 
in the London Medical Journals, the followin*^, italicizing 
certain sentences: Dr. Tripe stated that it was only at 
considerable elevations, such as eight thousand feet above 
the sea level, that the variations in the pressure of the at- 
mosphere was perceptible. People were then affected 
with so-called ''iiiountain sickness," which consisted of 
malaise; shortness of breath, palpitation of the heart, and 
nausea, with more or less giddiness and noises in the ears. 
Some persons s'uff'ered more than others; but nearly all in 
time become acclimated. Aeronauts suffered from the 
same symptoms, showing that great muscular exertion was 
not the chief cause of the attack. Those who lived on ele- 
vated mountain plateaus were observed to breathe more 
rapidly than those living at a lower elevation; their pulse 
increased in rapidity; and there w^as an increase in the 
evaporation from their skin and lungs, as well as a dimin- 
ished secretion of urine. It was believed that all the symp- 
toms were c7i/e/?^ r/^/i? ?'of/^^(^///;i/???<//o;i of oxygen in the air 
inspired, and consequentlij in the blood; and also to the imperfect 
exhalation of carbonic acid from the lungs. The influence on 
man, and especially on invalids, of diminished atmospheric 
pressure, and of a lessened amount of oxygen inhaled, had 
been much considered; and, while in some cases great 
benefit had been derived from a residence at high altitudes, 
and in others change of residence had been of little or no 

Variations in the pressure and temperature of atmos- 
phere exerted a considerable effect on the circulation of 
air contained in the 60//, or ground-air, which consisted of 
atmospheric air mixed with carbonic acid, marsh gas, and 
occasionally sulphurretted hydrogen. Rain also exerted 
great influence on the ground-water, and caused a rapid 
escape of air from the interstices of the soil. It was found 
that, when the ground-uater was only fve feet from the sur- 
face, the locality was unhealtJiy, and also that a fluctuating 
level led to ill-health among those residing on the spot. 
Outbreaks of typhoid fever had frequently occurred after 
heavy rain succeeding drouth, which were believed to 
originated from the infectious particles of typhoid excreta 
being washed into wells used for drinking. Damp soil was 
thought to be one cause of phthisis; and it had been shown 
that ejfective drainage of the land had caused a considerable 
diminution in the mortality of this disease. Wind in- 
fluenced to a great extent all meteorological phenomena, 
the humidity as well as the temperature of the air depend- 



Periscope. 339 

ing partly on the wind. Dr. Tripe pointed out that, though 
much had been written concerning the effects of ozone on 
man, yet but little was really known about it. It w^as aug- 
mented by violent winds, and was met with chiefly at the 
seaside, or in country f)laces. There was but little doubt 
that it exercised an active oxydizing action on the organic 
matter contained in the air, and w^as therefore absent in 
close, confined places where the air contained excess of 
organic matter. 

^ ^ ^ Dy, Tripe then referred to some papers 
already published by him on medical meteorology, in which 
he had stated the conclusions at which h» arrived concern- 
ing the relations between the mortality from scarlet fever, 
lung diseases, diarrhoea, and meteorological phenomena. 
He believed that the j^^r/or/ /re// occurrence of epidemics did 
not depend on meteorological phenomena, bid on the number of 
persons liable to the diseases living in the localitij. 

It is difficult to understand how the diminished oxygen 
inspired and augmented carbonic acid gas unexpired can 
fail to be injurious under the circumstances alluded to by 
Dr. 'Yvv^Q.— Louisville Med. News. 

Resorption in the Stomach. 

Dr. Tappeiner has communicated to the Zeitschf. Bilog., 
the results of his experiments on dogs, etc., regarding the 
powder of resorption exercised by the stomach. He put a 
ligature around the pylorus, and introduced solutions 
through an oesophagus-tube. He found that of watery so- 
lution of glucose, sulphate sodium, taurin, peptone, and 
strychnia very little was resorbed. But if he took alco- 
holic solutions, far more was absorbed than left in the 
stomach, and while, for instance, the effect of a watery 
solution of strychnia became only very gradually apparent, 
and in a mild degree, the same quantity of strychnia in an 
alcoholic solution, caused death in ten minutes. The effect 
was, however, not uniform, and he observed that the rapid- 
ity and the quantity in these absorption processes depended, 
to a great degree upon the quantity of fiuid previously in 
the stomach. With the pylorus closed, w^atery solutions of 
chloral had very little effect, while alcholic solutions caused 
sleep within a few minutes. Of the alcohol, always three- 
fourths was absorbed. This gives us an indication for the 
diet of persons suffering from cancer of the pylorus, or of 
indurtion or narrowing of this orifice, due to other morbid 
lesions. The nuritive material should be given in alcoholic 
solutions, and very little at a time, so that there is never 
much fluid at any one time in the stomach, and, for that 
matter, very little solid material also. All medicines, in 



340 The Peoria Medical Monthly. 

such cases, should be administered, dissolved in alcohol. — 
Med. Press. 

Lesions of the Teeth iu Locomotor Ataxy. 

At a meeting of the French Association for the Ad- 
vancement of Science, on Aug. 30, a communication was 
made by M. Th. David upon lesions of the teeth found in 
locomotor ataxy. The paper was based upon the observa- 
tion of a single case, and the following are the most im- 
portant of the conclusions arrived at from an attentive study 
of it. The alteration consisted of a rapid decay of the ante- 
rior part of the crown of almost all of the teeth. The altered 
substance assumed the consistence of touchwood and a 
reddish color. The enamel still retained its polish, but not 
its hardness. Beneath those parts the pulp had produced 
a new layer of second dentine, and in most of the front 
teeth the pulp-cavity was filled up. These alterations had 
nothing in common with caries, and must be referred to 
nutritive disturbance resulting from the lesion of the cen- 
tral nervous system. The changes are analogous to those 
which have already been observed to take place in the 
nails in the course of locomotor ataxy; they would thus es- 
tablish a pathological relationship between organs already 
connected by a common epithelial origin. Locally, these 
alterations recognize for their immediate cause a functional 
disturbance or a lesion of the dental pulp. The atrophy 
w^hich has been shown to exist would be quite comparable 
to that which is observed in the eye under similar circum- 
stances. Whence the final conclusion that we must at- 
tribute to the dental pulp the physiological significance of 
a sensory organ. — Med. Times and Gazette. 

A Prolific Family. 

The NewEngkoidMed. Mo nth I ij records the following case: 
Among the papers of the late Thomas Atwater, of New 
Haven, Conn., the following memoranda were recently 
found : 

" Mrs. Mabie, No. 100 Twenty-ninth street. New York, 
of the firm of Topping & Co., has been married forty-eight 
months. 

July 24th, 1858, had 1 child. 

July 30th, 1859, " 2 children. 

March 29th, 1860, " 2 " 

March 4th, 1861, " 3 " 

Feb. 13th, 1862, " .^ " 

Total 12 " 

These children w^ere all born within three years and 
seven months, and are all living and healthy. This is a 
copy from a memoranda given by the father, Mr. Mabie. 



Therapeutic Notes. 



341 



ibnaputif lot(i9i. 



NEKVr^TE AND ANTI-SPASMODIC. 

^ Potassi bromidi, 10 grains. 

Tinct.conii, 30 drops. 

Tr. valerinse amnion, 20 drops. 

Aquce camphorse, 1 ounce. 

M. A favorite prescription in the 
Hospital of Chest Diseases, London. It 
is useful in epilepsy, dysmeuorrha?a, 
chorea, hysteria, and the like. — 3Ied. 
Summary. 

VEGETABLE LIVER PILLS. 

j^ Leptandrin, 3^ scruple. 

Paeeophylin, jf scruple. 

Ex. belladonna, % scruple. 

Ex. nux Yom, J^ scruple. 

Pulv. ipecac, 5 grains. 
M. Ft. pil No. 30. Sig. One pill 

two or three times daily. — Druggists' 
Circular. 

APTHOUS SORE MOLTH IN INF.iNTS. 

:3 Sodii sulphitis, 30 grains. 

Glycerine, 

Aquse, each i.,' oz. M. 

To be used on a swab every two 
tours. — Coll. and Clin. Record. 

EXPECTORANT MIXTCRES IN BRONCHITIS. 

i^ Carb. of ammon, 1 drachm. 

Fl. ex. of squills, 

Fl. ex. of senega, each 2 drachms. 

Paregoric, 1% ounces. 

Water, 1 ounce. 

Syr. of tolu, 5 ounces. 

M. Sig. From three to four tea- 
spoonsful, as may be required. 

^ Muriate of ammon, 2 drachms. 

Ex. liquorice pulv., 1 drachm. 

Mucil. of gum arable, 

Water, each 3 ounces. 

M. Sig. Tablespoonful every two 
or three hours. 
5 Iodide of potassium, 2^^ drachms. 

Syr. of tolu, 

Glj'cerinfe, each 2 ounces. 

Sulph. morphise, 1 grain. 

M. Sig. Tablespoonful once in four 
to six hours. 

JJ Wine of antimony, 

Fl. ex. senega. 

Sweet spts. nitre, each 1 ounce. 
M. Dose. — One to two teaspoonful, 
as required. 

5 Syr. of ipecac, 

Syr. of squills, 

Paregoric, 

Sweet spts. nitre, each 1 ounce. 
M. Dose. — One to three teaspoon- 
ful, as required. — Med. Gazette. 



ACUTE ARTICULAR RHEUMATISM. 

5 Acidi salicylici, K ounce. 

Liq. ammon. acetatis, 2 ounces. 

Aq. distil, '^ ounces. 

S}T. aurantii cort., 1 ounce. 

M. SW. Tablespoonful in water 
every two^'hours.— i/ef?. and Surg. Be- 
porter. 

TONIC IN NERVOUS EXHAUSTION. 

5 Strychnia acetat., 1 grain. 

Acid acetici, 20 minims. 

Alcoholis, 2 drachms. 

Aq. distil, 6 drachms. 

M. Sig. Ten drops in water three 
times a day.— Amer. Med. Digest. 

SPERMATORRHCEA. 

5 Fl. ex. damina, 3 ounces. 

Fl. ex. coca, erythox, 1 ounce. 
M. Sig. Half an ounce three times 
a day. — Lancet and L linic. 

ANTI-PYRETIC. 

R Sulph. quinife, 5 grains. 

Tr. digitalis, lo minims. 

Phos. acid, dil., 15 minims. 

M. Sig. To be taken, properly^di- 
luted, once in four or six hours. Use- 
ful in pneumonia and other inflamma- 
tory fevers.— ^?ner. Med. Journal. 

NEURALGIA OF THE STOMACH. 

5 Bi-carb. potassa, 1 drachm. 

Acid hydrocyanic dil., 
Sol. morph. sulph., each 24 drops. 
Aqua; camphorse, 6 ounces. 

Sio- Teaspoonful as required. 
° —Louisville Med. Neics. 

TO PREVENT ABORTIONS. 

5 Ex. hyoccyami., 1 drachm. 

Ex. juglans cinerse, 

01. sassafras, 

Sodii bi-carb., 

Syr. simp., 
M. A teaspoonful of the mixture 
may be administered three times daily 
during the entire period of pregnancy, 
after the threatened abortion.— i/etf. 
Summary. 

SCALD HEAD. 

R Creosote, 30 drops. 

Acetic acid, 1 drachm. 

Oxalic acid, H drachm. 

Boiling water, 4 ounces. 

Mix and add both together. Shave 
the scalp and apply night and morn- 
ina;. — JJcleciic Med. Journal. 



1 drachm. 

1^ drachm. 

1^ ounce. 
6 ounces. 



THE 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South- Jefferson Street, .... PEOKIA, ILL. 

*** A.11 exchanges, books for review, and communications must be addressed to the 
Eiitorand Publisher. 

***The publication day of this journal is on or about the loth of each month 
***To subscribers! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



C^tUtorial gcpvtmfnt. 



A Question in Ethics. 

A card has been sent to us with the request that we 
give our opinion as to its ethical qualities. The card re- 
ferred to reads as follows: "Dr. X. Y. Z., physician and 
surgeon, Blanktown, U. S. Special attention to chronic 
cases." 

The question is regarding the propriety of the latter 
clause. 

In our opinion the card is in poor taste, and is beyond 
the limits of the code of ethics. Had the advertiser placed 
on his card, Practice limited to chronic cases, or diseases of 
the eye and ear, or diseases of women, we believe it would 
not have transgressed the bounds of propriety; but to put 
forth and distribute a general card as jihysician and sur- 
geon and then tack on a "special bid" for a special prac- 
tice, places the advertiser, in our estimation, in the rank 
and file of irregular practitioners, so far as the code of 
ethics is concerned. 



A New Medical College at San Francisco. 

This does not mean that a new faculty has been 
formed, etc., but the following extract from the Medical 
Record will explain: "A new building has been erected by 
Dr. L. C. Lane at a cost of about $85,000, on a lot worth 
$15,000, and conveyed by him as an unreserved donation to 



Editorial Department. 343 

the Cooper Medical College, which is a re-incorporation of 
the Pacific Medical College, the faculty of which remains 
unchanged. The college is named after Dr. Elias S. 
Cooper, now deceased." This item has considerable inter- 
est for the older physicians of Central Illinois, and especi- 
ally this city, as Dr. Cooper was for years a practitioner in 
Peoria, and Dr. Lane (his nephew) studied medicine with, 
him here. (We hope our exchanges will not explain that 
it is necessaiy for a physician to leave Peoria in order to 
gain a reputation.) 



The Bellevue Medical College of Massacliusetts. 

A circular has lately been issued by the Illinois State 
Board of Health exposing the above named institution^ 
We are sorry that our space will not permit of its insertiort 
in full, as it shows up one of these fraudulent schools in 
a laughable manner. 

Learning of the existence of such a college, the Secre- 
tary of the Board procured the writing of the following 
letter: 

Sprixgpeild III Oct 24 
Mr. Rufus King Noyes Esq Boston Mass 

Dear Sir will you please Inform me what are the Requirements and fees 
for Graduation at Your College also how long your corse of lecture is 

Yours Truly 

V B Kelly 
p S I have bin redin medesin about a year 

To this the following reply was received: 

Bellevve Medical College. 
Mr. Kelly: Bo;<ton, Mass., Oct. 27, 1882. 

Dear Sir: Enclosed please find circular of Bellevue Medical College. 

For graduation it is required that you be and feel competent [sic] in Diag- 
nosis, Treatment and Doctoral Conduct; that you can relieve human suffering-, 
and that you prepare an essay or a thesis and present to the College. 

The circular shows the regular five months course, but five months does not 
stand in the way of gmduating any competent person. If you cannot meet the- 
above requirements you can come with us and be prepared in private in Diag- 
nosis, Treatment or any other department of study in which you may be 
deficient. 

The regular fees are as named in the circular. In certain cases when extra 
attention is given an extra small fee may be charged. 

Sincerely, Kufts King Xoyes, M. D. 

On receipt of the above Mr. Kelly wrote again, enclos- 
ing his thesis on vaccination. We give both: 

SprinctFeild Illinois October 30 1883 
Dr Rufus King Noyes Boston Mass 

My Dear Dr Your esteamed favor came to hand this morning I can see no 
reason under your Rules why I Cant get one of your Diplomys I have bin Read- 
ing Medesin for a year and Besides that I hav ben tending on sick Purty near 
all my life so I hav a Purty Good idee About the Business I hav a Good Many 



344 The Peoria Medical Monthly. 

friends who I Doctor and they would Rather hav me for a Doctor than any body 
else for I can Cure them when other Doctors Cant I Can Diagnose a case every 
time But as I hav no Diplomy I cant Charge any feas so I nead a Di- 
plomy from a Good Colege but I aint got funds enufi' to so Thear and I 
aint got much edication Eather but I dont think a man must go''Through Colege 
to know how tu Doctor I know some Doctors who want to cranmi Thear 
heads with Theories and no Practiss and they are so Intolerable that they want 
Every Man to go to Colege but they are Rich and I am Poor and they want to 
crowd me out Because tliey are Afrade of Ue and if I had a Diplomy I could 
hold my own with the best of them These Doctors would not bother me If I had 
a Diplomy of the Bellevue Medical Colege and then they say I dont know Nuth- 
mg Because I Dont Beleave in Vacination But I hav seen EnuflF of that Business 
but I will write a Essay on that Thing and you can see what I think now Doctor 
I am poor and if you will give me a"Diplomy cheap I will do the Best I can for 
your Colege I think I hav showde you I am qualified and you can see what I 
-know By the Essay 1 send you You can send a Diplomy C. o. d. 
Address to Yours Truly 

V. B. Kelly Box 3027 Springfeild 111 
P s send rite away 

The following is a verbatim copy of what Mr. Kelly 
^'thiiiks about vaccination," forwarded with the above: 

VACINATION 

The Grate increase of Disease in thease Late years Calls for Explanation 
Undoubtedly the Doctors of this Day is to Blame for very Much of it But more 
than anything Else in My opinion is "the Inseartion into the Pure Blood and Vitle 
fluid of our Inosent oflspiing of that vile Diseas of the Animals cowpox So grate 
has the Curse Became that Privelidges of School Edication is Denide in this and 
Many other States to Those who wisely Refuse to Submit to this Curse this is 
just a Peace of the Xonsensickel Medical teachings of the Day when Theory and 
Imagination Rool Instead of Practical Expearance and wich keeps its Students 
in close Confinement a Big part of three or four years to hear the Nonsens wich 
is thear peddeld out to them consumtion Siffle's and Skin Diseas Runn Wild 
among the People This calls for a Strong kick on the Part of our noble ProfTes- 
sion which should seak to Build upp the Health and Streangth of the People in- 
stedd of Planting the Seeds of Diseas in Them To Prove thaf Vacination Dont do 
no good we nead ondly to say that Thear has Been More Small Pox in this Place 
in the last year than thear was in the last Nineteen or Twenty year and more 
deaths from it I neadnt say no more About a Thing that is so Plane to Eny think- 
ing man or Woman Eathar we should all Band ourselves togather in all Parts of 
the Country to Shut off this Cursed Practiss the People Should be tought Better 
But the Days is coming when Enlightenment will take the Place of Ignoranse 
and Prejudice and when that Time Comes these fanatics who live by Scaring 
People will hav to step aside and Vacination will not be Heard of any more 

By V B Kelly 

To these the following reply w^as promptly received: 

Mr. Kelly : Bellevite Medical College, Boston, Nov. 2, 1882. 

Dear Sir : You, as a candidate for graduation, have been favorably con- 
sz(Ze;Trf by the Faculty ; and your thesis has been examined by the Professors and 
found to be acceptable. In consideration that you cannot attend the college, you are 
required to purchase two tickets of matriculation. These tickets will show that you 
will have been under the instruction of the Bellevue Medical College for two years. 
These two years, together with the one you have studied by yourself, will make 
as much time spent in the study of med'icine as is spent- by any other medical 
student from any other college. "We believe you are and will ever be competent 
in Diagnosis, Treatment and Doctoral conduct. Of course you know every doc- 
tor has to continue his studies after he has taken his diploma. You are correct 
on tht Vaccination question, and I am confident you will meet with continued 
success. Your diploma will be sent 0. 0. D. one week from the date of this letter. It 
■will be securely packed in a pasteboard box. Your bill for diploma and two 
tickets is $150.00. The tickets and diploma go together. The one cannot go 
without the other. President. 

Without quoting more from this interesting corres- 



Editokial Department. 345 

pondence, suffice it to say the diploma was sent by express, 
C. 0. D., and the swindle fully exposed. The Secretary of 
the Board of Health closes his circular with the following 
pertinent remarks: 

Comment on the foregoing would be entirely superfluous were it not that 
this travesty on much that goes for medical education in the United States is so 
ludicrous as to mask the satire it contains. It would not be difficult to parallel 
the tenor of the Third Year's Announcement of the Massachusetts Bellevue with 
announcements of older institutions not chartered as " manufactured corpora- 
tions." Nor is the mode of making out the necessary time " spent in the study 
of medicine" entirely unfamiliar to many colleges which claim to be in good 
standing, and which, unfortunately, are accepted as such. How many ignor- 
amuses with not one whit more of' education, either literary or medical, than is 
displayed in the essay on " Vacination," are every year turned loose upon the 
public, each bearing a " diploma " reciting that some particular Rufus King 
Noyes and his colleagues have adjudged and decreed the bearer (in the sonorous 
Latin of the Bellevue sheepskin, price $150, C. O. D.), hominem egregium studiis 
opitimus deditum — a distinguished man devoted to the noblest pursuits — digiium 
atque idonenm qui honoretur altissimo dignitatus gradu — worthy and fit to be 
honored with the highest mark of distinction. Having sufficiently investigated 
(as to his scientific and scholarly attainments), — satis compertum explorntumque 
habemus, — as witness the thesis on " Vacination," we, to-wit : Rufus King Noyes, 
with one consent — uno animo — have created and made — creavimus etfecimue eum 
Doctorem Medicince — literally " manufactured " him into a doctor! 



ISTotes and Comments. 

There are 215 professors in the University of Berlin. 
Chicago has good reasons to hope. 

Short crop of Norwegian cod-liver oil this year. Look 
out for an advance in the linseed oil market. 

Nine states still lack Boards of Health, Some of those 
liaving this treasure now wish to have them remodeled. 

Dr. Kingston, of Montreal, recently removed an ovarian 
tumor from a child of two years. The child was in a fair 
way to recovery. 

In reply to a suggestion that he establish a hospital 
for fallen women, the Emperor of Austria said that he had 
not enough money to roof over the whole of Vienna. 

In Providence, R. I., with a population of 104,000, not 
a single death from small pox has occurred since 1875. 
The reason given is "general and careful vaccination." — 
Exchange. 

Quite a number of states have passed laws forbidding 
the sale of the toy pistol. We hope the Illinois Legisla- 
ture will not forget the subject at the coming session. Dr. 
Rauch should keep it before them. 



346 The Peoria Medical Monthly. 

Dr. Oliver Wendell Holmes has resigned the chair of 
anatomy at Harvard, which he has filled for thirty-five 
years. His time will now be devoted exclusively to litera- 
ture. AVho says Boston baked beans is not a healthy diet? 

A homoeopathic physician in Switzerland advertises 
that he performs '"surgical operations mUder than any 
physician of the other school." At last we know what a 
homoeopathic surgeon in.— Chicago Med. Jour, and Examiner, 

In filling out a "birth return" in a case in which the 
name of the father was doubtful, a Chicago doctor, with 
prompt exhibition of forethought equal to any emergency, 
filled in the blank E Plurihus TJnum. The name of the 
child perhaps might be given as Erin go brah. 

Wife (to a doctor just home from a week's hunt- 
ing): "Well, James, did you shoot anything?" Doctor 
(sadly): "No. Awfully bad luck; never killed a thing." 
Wife (who knows him, sweetly): "My dear, you would 
have done better if you had stayed at home." — Med. Becord. 

The wife of Dr. E. C. Sequin, of New York, in a fit of 
insanity, shot her three children and then herself All 
w^ere dead when discovered. The doctor has the sympathy 
of the profession in his dreadful affliction. He has gone to 
Europe for the winter to escape the memories which must 
render his home a torment. 

Quite a number of subscriptions have expired during 
the past few months, but we have neglected to mark the 
proper place to notify our friends of the fact. We hope 
every one knowing that his time has expired will promptly 
forward his renewal at once, whether his journal is marked 
or not. Please attend to this small matter at once. 

The health officers of Cincinnati are accused of making 
false reports about small-pox, and that they have concealed 
the true number of cases. The city is greatly alarmed and 
fears there will be a general epidemic this winter. The 
Chicago health officers did the same thing last winter to 
the tune of a thousand or two cases, but nothing was said 
about it when it was found out. 



Editorial Department. 347 

In Indianapolis it so happened that the doctors' con- 
vention was held first, then the druggists', then the under- 
takers'. That is generally the way it goes — first doctor, 
then druggist, then undertaker. — Indianapolis Pharmacist. 
In this neck of the woods the order is frequently reversed, 
and reads: First druggist, then doctor, then undertaker. 

A visiting committee to a hospital came to the second 
bed from the door of a ward. " Well, my man, how are 
you getting on? Can we do anything to make you more 
comfortable?" The patient expressed a wish to exchange 
beds with the one next to the door, and on being pressed 
for the reason, said: "That man is my bitterest enemy. 
The doctors always come in at that door, and they put the 
same thermometer in my mouth that has just been in that 
man's stern." — Exchange. 

The Illinois State Board of Health has collected much 
valuable information concerning medical colleges, which it 
has had printed in pamphlet form. From it w^e take the 
following interesting statistics. It includes the United 
States and Canada: 

Total number of colleges given 175 

Total number now in existence 119 

Total number of colleges whose diplomas have been pre- 
sented to the Board and recognized 99 

Number recognized conditionally 18 

Number not recognized 18 

All of the latter two classes are in the United States. 

Number of colleges absolutely requiring attendance on 

three courses of lectures 17 

In the United States 8 

In Canada 9 

Total number of matriculants, session of 1881-82 13,094 

In the United States 12,454 

In Canada 505 

Graduates since 1882 4,380 

In the United States 4,299 

In Canada 81 

Per cent of graduates to matriculation: 

In the United States 34.6 

In Canada 14.6 

Highest per cent.: 

In the United States 83 

In Canada 23 

Lowest per cent.: 

In the United States 9.0 

In Canada 2.6 



348 The Peoria Medical Monthly. 

The Michigan University Medical Department is in hot 
water again. Dr. MacLean has sued somebody for $50,000 
as damages to his character. Somebody else has sued Dr. 
MacLean for the same amount. The preachers are whack- 
ing away at Dr. Frothingham for heresy, and there seems 
to be a " dickens of a row all around," with our friend Mul- 
heron still to hear from. 

The Canada Medical and Surgical Journal is authority 
for the statement that " Dr. Bellield, of Chicago, will de- 
liver the Cartwright lectures in New York this winter." 
We hope this is true, as it would be a fine compliment to a 
well-deserving gentleman. He is a young man and he lives 
in the west — two things which enhance the value of the 
appointment coming from New York. 

Receipts for November and December. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card : 

Illinois — Drs. M. M. Robinson, John Farrell, J. J. McKibben, J. 
A. Van Drelzen, D. McCreed, H. B. Sikes, E. V. Anderson, C. S. Dick- 
son, Emil Haas, Chas. Scott, A. T. Mobley, W. M. Johnson, J. D. 
Camerer, Jno. Stout (two years), F. W. Dimmitt, S. Russell, W. F. 
Millen. 

Iowa — Drs. J. H. McCune, Kittle, J. Gamble, J. Lewis, E. A. 

Whetstine, J. J. Whitney, M. Enfield, N. W. Hayes, J. M. Payne, J. G. 
Williams, J. C. Tribbett, I. W. (harder, Adair & Beck, M. C. Boggs, J. 
W. Firkins, N. M. Smith, G. W. Bellus, V. R. King, D. W. Overholt. 

Nebraska — Drs. F. A. Long, H. B. Daviess, H. T. Cooper, B. H. 
Colbury, J. S. Hoyt, Alice E. HufF, A. Taylor, Emma Watkins, Jos. 
Neville, W. L. Bowman, J. R. Brooke. 

Kansas— Drs. G. W. Haldeman, W. W. Carter, D. O. Hopkins, W. 
S. Newlon, Daniels & O'Flyng, W. D. Matuey, C. C. Corkins, D. W. 
Mason, H. C. Miner, J. M. Ennis, R. J. C. Dodds, G. H. Brown, W. H. 
Wells, A. Puderbaugh, E. N. Stearns, T. J. & A. A. Cowry, J. P. Scoles, 
J. H. Seaton, W. Morton, A. G. Murshman, J. D. Bryan. 

Missouri — Drs. A. M. Smith, C. A. Wicks. 

Oregon — Drs. Ralph Leonard, J. F. Grimm. 

Kentucky — Dr. F. J. Sullivan. 



The Peoria 
MEDICAL MONTHLY. 



You III. JANUARY, 1883. No. 9. 



©rigiunl (filommuuifationisi. 



Art. I.— Intestinal Obstrnotion. By John L. Hamilton, M. D., Peoria, 111. 
Read before tbe Peoria City Medical Society, December 4, 1882. 

Mr. President and Members of the Society: 

I present to yon this evening a short paper on the sub- 
ject of intestinal obstructions. These are usually due to 
one of the following causes: Constipation, compression, 
stricture, strangulation, impaction, or intussusception. The 
description of a case arising from any one of these causes 
may appear plain, and one, you might think, very easily 
diagnosed ; and it is true we may easily learn that we have 
a case of obstruction of the bow^els, yet in practice I hardly 
know of any condition so surrounded with difficulties in 
making a definite diagnosis of tlie kind of obstruction w^e 
have to treat. There are three symptoms almost con- 
stantly present in all of the ol^structions. These are pain, 
vomiting and constipation. Pain is always present, but 
may vary in its mode of coming on, duration and intensity, 
and it sometimes is an important diagnostic symptom. If 
little pain is produced by handling the parts, or a sense of 
relief is experienced by pressure upon the bowels, we may 
infer there is no inflammation present ; that the case is 
probably one of colic, due in part to" gaseous distension. If 
acutely tender on pressure, the inference is that peritonitis 
•exists; or if pain is only elicited after deep pressure, enteri- 



350 The Peoria Medical Monthly. 

tis may be suspected. But whether pain exists without 
inflammation, or with peritonitis and enteritis, the"peri- 
staltic action of the bowels always increases it. 

The pain is not always over the seat of obstruction. 
When the small intestines are involved the pain is usually 
found to be in the region of the umbilicus. The tendency 
ot the pain, in all of these cases, is to be more or less- 
spasmodic. 

Vomiting is rarely, if ever, absent in obstruc- 
tions, from whatever cause. Usually, at first, it is sympa- 
thetic. After a time it is due to the regurgitation of fluids 
into the stomach. We find the closer the obstruction is to 
the stomach the more constant the vomiting. If it is in. 
the larger bowels the vomiting may produce but little 
trouble. Stercoraceous vomiting, as it is called, which is al- 
ways a bad symptom, may be entirely absent if the disease 
is near the upper portion of the intestinal tract. The 
vomiting is peculiar in these cases. It pours from the 
mouth with but little effort, and is not usually attended 
with much nausea, only distress and fulness complained of. 
Constipation is another of the symptoms accompanying 
this condition. Still we may have discharges from the 
bowels, it being the contents that is being carried off from 
below when the obstruction has taken place. And in stric- 
ture, when the bowels are not entirely closed, their fluid 
contents may be allowed to pass, and give rise to the 
opinion that there are free fecal evacuations, or remain in 
the lower bowels until it becomes of some con.sistence and 
passes in a natural condition, especially if the constriction, 
is high up in the tract. Also in impactions the fluid con- 
tents of the bowels may make its way around or through 
the impactions in such quantities as to lead us to the 
opinion that the obstruction has been removed. The same 
may occur in intussusceptions and in invagination. 

When bloody discharges follow soon after the obstruc- 
tion takes place, we may suspect intussusception. While 
these conditions may occur in all these obstructions, yet it 
remains a fact that obstinate constipation is one of the 
most frequent symptoms. A tympanitic condition of the 
bowels usually takes place in this case unless the part 



Original Communications. 351 

affected is very near the stomach. The nearer the rectum 
the obstruction is the more general will be the tympanitis. 

It is only in rare cases that a manual examination of 
the bowels will reveal the seat of the obstruction, unless it 
is impaction. In some cases of intussusception the tumor 
may be felt, and when felt we cannot always say it is a 
case of intussusception, but it reveals to us the portion of the. 
intestines implicated, and if an operation is to be performed 
is of great importance. We may learn something in these 
cases from the amount of urine passed. If it is free and of 
natural quantity, it is not likely that the obstruction is 
near the stomach. If suppressed and scanty, it would indi- 
cate that the obstruction was so near the stomach that but 
little absorption is taking place. 

The manner of invasion is alwaj^s an important fact ta 
learn. Strangulation and intussusception come on suddenly^ 
with acute pain, while the gradual approach ot stricture 
and impaction, if we can get a correct history with the 
accompanying symptoms, will usually lead us to a correct 
diagnosis. 

That condition known as bilious colic is an obstruc- 
tion accompanied with inflammation of the muscular coats 
of the intestines, and if not too actively treated may con- 
tinue for days, or even weeks, without any discharge from 
the bowels, and even then the patient recover. I had a 
patient a few years ago in whom the inflammation con- 
tinued for three weeks. During all this time there was no 
evacuation from the bowels. At the end of that time they 
moved off" naturally, and my patient recovered. It was 
caused by the person drinking ice water when very much, 
heated. 

The duration of life in these cases depends very much 
on the acuteness of the attack. Fatal results are usually 
more rapid in cases where the obstruction is near the 
stomach. Obstruction in the colon or rectum, if it is not- 
complete, may last for wrecks, or even months, without a. 
fatal termination. Intussusception and strangulation are 
usually rapid in their course, and, if not relieved, a few 
days may end the life of the patient. One thing should 
never be omitted in examining these cases, especially if 



■352 The Peoria Medical Monthly. 

there are symptoms of strangulation: Always to make a 
careful examination of the different points when hernia 
may occur. I once saw, at a post-mortem, where hernia 
was not suspected, a loop of the intestines stranjj:ulated 
just within the internal inguinal ring, causing the death of 
the patient, which was not discovered by the attending 
physicians. 

Tumors may press upon the intestines in such a way 
as to cause obstruction, or, as often occurs in cancer, the 
bowels become implicated in the tumor so as to cause per- 
manent obliteration of them. In these cases the tumor 
€an usually be felt, and from the other symptoms a correct 
diagnosis be made. Large gall-stones have sometimes 
caused obstructions by lodging in some portion of the 
bowels, or something the person has swallow^ed may act in 
the same way. I have no doubt this often occurs in chil- 
dren. I had a child this last summer with an obstruction 
in the rectum, wiiich was quite difficult to remove. After 
getting it away it was found to be a mass of grape seeds. 
The child had gone into the j^ard among the grape vines 
and eaten a large quantity of grapes. • Gall-stones may 
lodge in some portion of the intestines and remain a long 
time. Even for years do these large stones pass through 
the common gall-ducts. They have been found in the in- 
testines after having passed from the gall-bladder into the 
duodenum by ulceration. It is possible that some of those 
found in the bowels, of large size, have grown by concre- 
tions forming around them after their entrance into the 
bow^els. This may account for the very large stones some- 
times found there. The portion of the bowels in w-hich 
they are lodged tolerates their presence and accommodates 
itself to their slow growth. It is well to remember that ob- 
structions of this kind do occur, and that they may be the 
cause of the tumors sometimes felt in the bowels that are 
difficult to account for. In obscure cases of intestinal ob- 
structions a manual exploration by the rectum will some- 
times assist greatly in making out a correct diagnosis, and 
if done early in the disease wdll do no harm. In treating 
acute intestinal obstructions we should be careful to avoid 
purgatives even in the mildest forms, unless we are well 



Original Communications. 353 

convinced that we have a case where fecal accumulation is 
the principal cause and it is unattended with inflamma- 
tion. Then the mildest form of cathartic only should he 
given. Castor oil, the salines, with enemas, will usually 
relieve. 

Opium in some form is usually the appropriate remedy, 
and it should be given in sufficient doses to relieve pain 
and procure rest. Little food should be given, for it is 
usually rejected by the stomach. What is given should be 
in small quantities and of the kind most easily appro- 
priated by the absorbents. Opium in these cases not only 
relieves the pain and quiets the patient, but it often pre- 
vents inflammation, and in some cases, by its relaxing 
efi'ects, acts as a cathartic, as we often find it to do in bad 
€olic. 

Functional constipation, with colic, is a very common 
complaint. In these cases cathartics in some form are the 
remedies. It is important to recognize these cases from 
the more serious cases of obstruction. Injecting large 
quantities of warm water will sometimes relieve. A good 
way to throw in the water is by means of a s3^phon tube. 
Take a rubber tube three feet long ; introduce one end into 
the rectum. After placing the patient into the knee and 
breast position, place the other end in a basin of water 
held a little higher than the patient, then start the water 
by exhausting the air in the tube by pressing along it. 
The hydrostatic pressure obtained in this way is very great, 
and must not be continued too long for fear of doing vio- 
lence to the bowels. Cases of intussusceptions and constric- 
tions by bands, if not too firmly held, may be relieved in 
this way. 

The great tolerance of the intestines, observed in the 
manipulations in the hands of the ovariotomist, leads us to 
suppose that many of the cases of obstruction might be re- 
lieved by opening the bowels and searching for the intes- 
tinal obstruction. One reason, perhaps, that laparotomy 
is not more successful than it is, is because it is* resorted to 
only as the last resort — when the powers of nature are be- 
comino: exhausted. After other means have failed, and 



354 The Peoria Medical Monthly. 

especially if the portion of the bowels implicated can be 
ascertained, I think the operation should not be delayed, as 
it is known to have been successful in many cases. 



Art. II.— Venesection as a Therapeutie Agent. By Robeut Boal, M. D., 
Peoria, 111. Read before the Peoria City Medical Society, Dec. 19, 1882. 

" The times have changed, and we have changed with, 
them." Thus wrote the Roman poet centuries ago, and the 
expression is as true now as when it was w^ritten. Fashion 
prevails in the practice of medicine as well as in dress, and 
the favorite mode of to-day may be supplanted by a new 
and fresh one to-morrow. For a time some new therapeu- 
tic agent will be introduced and ride upon the very crest 
of the wave of popularity, then suddenly subside and be 
forgotten. As garments which are out of fashion are- 
throw^n aside and consigned to the rag basket or the " old 
clo* '" dealer, so many therapeutic agents w^hich w^ere form- 
erly considered essential to the successful treatment of 
disease, have been thrown away or relegated to the limbO' 
of forgetfulness. Among those who have shared this fate,. 
blood-letting is, perhaps, the most prominent. When I say 
blood-letting, I mean the abstraction of blood by the three 
modes of venesection, cupping and leeching. A third of a 
century ago all these modes of abstracting blood from the 
human system w^ere of common and every-day occurrence. 
The lancet, scarificator and leeches were used as often a& 
the hypodermic syringe, the thermometer, stethoscope and 
other instruments are to-day, and I am free to say, with as 
much success in the treatment of disease then as now- 
That a remedial agent, capable of accomplishing so much 
good if properly used^ — one so effective in relieving i^ain, 
counteracting inflammation, removing congestion, and 
equalizing the circulation in the large blood vessels and ca- 
pillaries, should have fallen into almost entire disuse, is a 
striking illustration of the fickleness and power of fashion 
in therapeutics. We need not, however, go far to ascertain 
the causes which have led to the almost total disuse of 
blood-letting as a therapeutic agent. Upon the advent of 
the ''eclectics," as they falsely style themselves, some 
thirty-five or forty years ago, the first onset was made upon 



Original Communications. 355 

the practice of blood-letting. They denounced it, asserting 
loudly, in the words of the " Mosaic law," that the " blood 
was the life," and if any portion of it was taken away, just 
so much of life was lost. This notion took hold of the 
popular mind, and by degrees the practice of blood-letting 
became less and less, until it was almost entirely aban- 
doned. To their aid came the homoeopaths, who w^ere 
with them in their condemnation of the practice. Last^ 
but not least, they were effectually assisted by the fellow^s 
with long hair, buckskin shirts and broad-brimmed hats, a 
species of medical guerilla who hang upon the flanks of the 
profession, fllHng their pockets and gulling the credulous. 
With all these forces joined in the attack, is it any wonder 
that blood-letting ceased to be employed as a therapeutic 
agent ? Nor was the regular profession proof against these 
attacks. They succumbed to the popular clamor raised by 
empirics and knaves, and deprived themselves of a thera- 
peiitic agent so powerful for good in the hands of the in- 
telligent and educated practitioner. That this remedy was 
abused, all admit, and the reaction in consequence of this 
abuse increased the number of the opponents of blood- 
letting and diminished that of its defenders. It has been 
urged by some that the constitutional changes engendered 
by the luxurious and artificial habits of the present age,, 
afford a good reason why blood-letting should be aban- 
doned. Admitting that the change has occurred, especially 
in crowded centers of population, it may be a good reason 
for limiting the use of the general and local abstraction of 
blood to a less number of cases, but not for its entire aban- 
donment. We are too much given to rely upon the dicta 
of distinguished men in the profession, and we have lead- 
ers in medicine as well as in politics. The opposition of 
Skoda and others in Germany, Gusoleein France, and Ben- 
nett and Todd in Great Britain, has done much to bring the 
lancet into disrepute. And while the controversy between 
the advocates and opponents of blood-letting has been 
earnest and sometimes bitter, the true ground is perhaps 
that taken by an influential medical journal some years 
ago, which sums the matter up as follows : 

"While the non-bleeding plan has a demonstrable ad- 



356 The Peoria Medical Monthly. 

vantage over that of indiscriminate and repeated bleeding, 
we maintain that the discriminating practice of moderate 
and early bleeding, general or local, in cases of more or less 
sthenic inflammation and of refraining from it altogether 
in asthenic cases, whether as regards the character of the 
disease or the constitution of the patient, is pressed upon 
us both by experience and science." 

The use of the lancet and local blood-letting is one of 
the most ancient and universal remedies in the treatment 
of violent inflammation and congestion. Now what do we 
expect to accomplish by either the general or local abstrac- 
tion of blood ? We lessen the fullness of the vessels by 
relieving their tension ; we diminish the number of the 
Ted corpuscles and lessen the force of the heart's action ; 
we allay the excitement of the nerve centers and diminish 
the force of the arterial impulse. I do not believe with 
Bennett and others that inflammation is a "self-limited 
process which cannot be cut short or interfered with to ad- 
vantage." On the contrary, speaking from the experience 
and observation of many years, I am convinced that con- 
gestion and inflammation can be modified, if not subdued, 
by early and judicious blood-letting, either general or local; 
and further, in many cases I believe it is one of the surest, 
mildest and safest of remedies. It has often been urged by 
the opponents of blood-letting, that it reduces the strength 
and vital powers of the system. This, in my judgment, is 
neither its oljject nor effect. We aim not to reduce the 
strength of the patient, but only to reduce the vascular 
excitement ; in other words, to equalize the circulation and 
l)revent congestions or determinations of blood to particu- 
lar organs or tissues. I have seen many cases where a 
moderate general or local abstraction of blood instead of 
lessening the patient's strength actually increased it. You 
may pile weights upon a man lying down, so that he can- 
not rise. He has as much strength as before the weights 
were placed upon him, but he cannot use it. Take away 
one-half the weights and he can get up and move about as 
well as ever. The man lost no strength, but it was over- 
come by superior force. So the system or a particular 
organ may be weighted down, so to speak, b}^ general 
23lethora, active congestion or sthenic inflammation. Re- 



Original Communications. 357 

move or reduce these weights by abstracting blood and you 
give instead of taking away his strength. Now^ for what 
forms of disease may we use general or local blood- 
letting : 

1. We may abstract blood in inflammation of high 
and active grade, in whatever organ of the body it is 
present. 

2. In cases of congestion or engorgement, threaten- 
ing hemorrhage or inflammation. 

3. In a general plethoric condition of the system,. 
threatening inflammation, congestion or hemorrhage from 
some jDarticular organ. 

4. In spasms or convulsions of a sthenic character. 
These are the principles upon which blood-letting 

should be based, and they are as old as the practice itself. 
To illustrate by example: In meningitis, occurring in a 
strong vigorous person of full habit of body, blood-letting is 
one of the most efficient agents in subduing the inflama- 
tion. The brain from its anatomical relations, being shut 
in by the hard and unyielding skull, is subject to conges- 
tion or inflammation, to great vascular pressure, and as I 
have said, in proper subjects there is no such speedy, safe 
and efi'ective agent in diminishing or removing it as blood- 
letting. The same may be said of the lungs and their in- 
vesting membrane, the pleura. They are closed and confined 
by the walls of the chest. Vascular pressure is marked in 
pneumonia, although not to the same degree as in menin- 
gitis. Formerly the almost universal practice was to bleed 
in pneumonia, especially in the early stage. Xot once, but 
often twice, or even three times, and if the bills of mor- 
talities could be examined I have no doubt they would 
show as low a percentage of deaths as under the modern 
non-bleeding treatment. I well remember that forty years 
ago, when President Harrison died of pneumonia in Wash- 
ington, to have heard the expression from several eminent 
western physicians that if he had been bled and treated as 
pneumonia was treated in Illinois he might have recovered. 
I mention this incident to show how important blood let- 
ting was then regarded in the treatment of pneumonia. 
In what we now know as uremia venesection was fre- 



^58 The Peoria Medical Monthly. 

quently practiced with beneficial results. They did not 
know it then by that name but called it inflammatory 
dropsy. In pregnacy venesection was often resorted to, 
and it was an almost univeral practice to bleed a pregnant 
woman if she exhibited any evidence of full habit. It was 
also iDracticed during labor if the pains were grinding and 
the OS uteri and the soft parts rigid, and, while I would not 
advocate the revival of the practice, except in rare cases, I 
know from experience that it did a great deal of good. Ii. 
pueiperal convulsions, from whatever cause they may arise, 
if the woman is stout, well developed and of full habit, I 
regard venesection as one of our most efficient agents in ar- 
resting them. I have seldom witnessed a fatal case of con- 
vulsions when venesection was properly used. While 
chloral, veratrum and other agents are useful and often 
efficient adjuncts in the treatment of this appalling afl'ec- 
tion, they can seldom take the place of bleeding. These 
are a few of the diseases to which blood-letting is applica- 
ble. Others as apoplexy, certain cardiac affections, etc., 
might be cited were it necessary. As to the quantity ot 
Mood to be abstracted in venesection that must be left to the 
judgment of the practitioner of its effect upon the pulse. 
In bleeding by cupping and leeching, oftentimes the most 
rapid and beneficial effect is produced. Their revulsive ac- 
tion is well marked. It is said that cupping has, in addi- 
tion to its revulsive, more of a counter irritant effect than 
leeching. When the parts from which local abstraction of 
blood is to be made are tender, as in an inflamed joint, in 
pleurisy, in peritonitis, leeching is to be preferred as less 
irritating than cupping. In venesection a small amount of 
blood will do more good and it will require less to produce 
the same effect if it is drawn while the patient is sitting up. 
When blood-letting was in vogue this was the almost uni- 
versal practice. It economised the loss of blood and from 
the partial or complete syncope which generally followed, 
the excitement of the heart and arteries, and the active 
determination of the blood to the diseased organ or tissue 
was modified or lessened. It cannot be denied, even by the 
opponents of blood-letting, that it is a potent therapeutic 
agent. Its abuse in the past should not exclude its proper 



Original Communications. 359 

and judicious use in the present. Why should we discard 
a valuable remedy because of a popular prejudice against 
it? I do not wish to be counted as an advocate of blood- 
letting as a general practice, but as I have already said 
there are many causes in which it might be used to the 
advantage of the patient and the credit of the doctor. Par- 
ticularly is this the case with regard to local bleeding. In 
my judgment, if cupping or leeching were oftener resorted 
to our success in the treatment of many ailments would be 
greater than it is now. My object in presenting this im- 
portant plea in behalf of blood-letting has been to call the 
attention of the younger members of the profession to a 
valuable remedy, of which they probably know little, ex- 
cept from reading. Of the several thousand graduates from 
our medical colleges within the past few years, it is ques- 
tionable whether two per cent, of that number ever opened 
a vein in venesection or know the use of a spring lancet 
when they see it. And it may also be safely said that very 
few of them ever used the scarificator and the cups, or ever 
ordered, much less applied a leech. Neither you nor I, Mr. 
President, may live to see it, but it is not unlikely that in 
the "chances and changes of this mortal life" or the muta- 
tions of fashion, the good old remedy of blood-letting will 
be again restored to professional and popular confidence 
and occupy the place in our therapeutics to wdiich it is 
justly entitled. 

Akt. III.— The Michigan University Trouble. By C. B. Maclay, Delavan, 111 

As this is the era of free speech, it is not to be won- 
dered at, that liberty often becomes license, and when op- 
portunity offers that many of our public teachers do not 
resist the inclination to strike at dogmas which they reject 
rather than to render a reason foi- their own unbelief. 
Especially is this apt to be the case when the audience is 
composed of learners who are sitting at the feet of learned 
professors, and who are just in that condition of mind to 
be easily swayed by a positive decision. In the medical 
lecture-room particularly, it seems to be true, that when 
reference is made incidentally to any religious custom, his- 
torical incident, or article of faith pertaining to christian- 



360 The Peoria Medical Monthly. 

ity, there are professors who so far forget themselves as to 
throw out innuendoes or to sneer, perceptibly. The writer 
has heard this trouble years ago, and late students report 
the custom still prevailing. Even the learned and cele- 
brated Dr. Gross was heard to express during his last course 
of lectures, a suspicion that the woman whom the scrip- 
tures describe as "blessed among all women," was a 
woman of the town ! Tis painful indeed to think that any 
man of scholarly attainments can stoop so low or wantonly 
thus offend. No matter how men differ in opinion, nor 
how strong their prejudices may be, it is neither wise nor 
prudent for them to take advantage of the platform to 
throw mud. Respectful argument, if in place, should al- 
w^ays be heard without a murmur. The fact is before us 
that many medical men have never had an opportunity of 
studying mental and moral philosophy and are not at all 
versed in metaphysics, and are therefore in no condition of 
mind to weigh arguments for or against questions of a 
purely metaphysical, or mental or moral character. It is 
to be expected that minds thus untutored are apt to run 
from the very outset, in the study of medicine, toward the 
basest materialism, and spurning Christianity and all its- 
teachings regarding the human soul, to turn aside to some- 
thing no better than civilized animalism. It is also true 
that learned men who are dealing with nature's secrets^ 
and unfolding the glories of her law^, do become so blinded 
by their very devotion to the rule of second causes, as to 
relegate the great first cause to the regions of oblivion. 
The parallel exists in the case of men of great mechanical 
skill and acuteness of perception, as to ways and means, 
who have spent time and money and do yet labor for the 
invention of the perpetual motion, when it is obvious that 
no machine can make power, but is simply a mode of com- 
munication, receiving and transmitting with even a high 
percentage of loss. Uneducated minds the world over set 
vision before perceptifm, and visible results always in ad- 
vance of design. It is said "nothing succeeds but success," 
but after all what men call success is wdiat they can behold 
with the eye. The grandest and most glorious successes 
are only realized by the contemplative and far-seeing 



Original Communications. 361 

minds that are not fastened upon or blinded by the bril- 
liancy of a single object in a special direction. Scientific 
men, who pride themselves on the name, ought not to be 
too eager in holding up to derision what they call religious 
fable when they remember the vagaries of their own class. 
It may be triumphantly stated that there is now no theory 
received and endorsed largely by the scientific world but 
has been at some time, in the history of science, denied, 
derided and spurned by intense partisans in the scientific 
domain. It is well known that '' oppositions of science 
falsely so-called," as Paul terms them, have always bristled 
with antagonism to religion ; as it is also true that many 
religionists regarding anything in any way seeming to con- 
tradict the testimony of the Bible, have thought them- 
selves called upon to battle in the cause, as the disciples of 
Christ on one occasion wished to call down fire from heaven 
on the people who would not receive their Master's com- 
pany. It is to be hoped that the day of controversy for the 
sake of controversy, has passed away, and that no man will 
needlessly depart from any given line of thought to strike, 
to destroy or even wound an adversary, but all discoveries 
be in the line of truth, and every purpose to speed the day 
of man's mental, moral and physical thorough culture. 
When a lecturer finds himself compelled to give his opinion 
adverse to christian dogma, let him do so, deliberately but 
politely, and not forget to state that it is an opinion and 
his own. Let men desist from setting forth theory as fact, 
and supplying missing links from their own imaginations. 



Art. IV. — Compensation to Surgeon.s and Pliysicians, Especially Relating to 
the President Garfield Audit. By Hiram Nakce, M. D , Kewanee, 111. 

I want to premise, in the remarks I may hastily make, 
that I am decidedly in favor of being well paid for my 
surgical and medical services, and at the same time have 
no jealously towards anyone in our profes.sion, but will .say 
I am uncompromisingly opposed to over and exhorbitant 
charges in anything, and especially in our profession, and 
particularly when our practice is confined to city, county, 
state or national patients. No physician has any right, nor 
is there any justice in making an extra or over-charge, for 



S62 The Peoria Medical Monthly. 

such professional business, and this applies in the case of 
our lamented president. 1 have repeatedly seen in our 
county board of auditors bills made, reduced from the 
amount claimed by physicians making them for services 
performed for paupers, and not unfrequently pay entirely 
refused. This refusal had become quite common since the 
erection of countj^ poor houses, and the employment by 
contract of physicians in nearly every town in the country. 
This town contract business is an outrage. A few of our 
petty town officials slip around amongst the physicians and 
quietly whisper that the contract for attending paupers 
will be let to the lowest bidder, but they are always sure to 
only make this known to their special physician friend, and 
of course he gets the business. He may be a man of tal- 
ent and fine medical attainments, but the contrary is gen- 
erally the case, and he is usually paid not over half what 
the services would really be worth if performed by an ex- 
perienced and cultivated physician. This is certainly 
wrong. Is it a crime to be poor, and should our pauper 
population not receive equal treatment with those more 
fortunate in the possession of a competence ? In fact they 
are treated as criminals. They can't say a word in regard 
to the selection of their medical adviser, and if one of 
them becomes suddenly ill and employs a physician who is 
not the town physician, when he presents his account to 
the county board it is flatly refused, and there is no alter- 
native but to lose it. I have seen so much of this kind of 
business that I am disgusted, and now I never pretend to 
j^resent a bill to our county officials for adjustment and 
payment. If I attend a pauper I do it knowing that my 
reward is not of this ivorJd or this county. Of course all 
counties and all cities should have one or more physicians 
constantly employed to look after their hospitals, alms- 
houses, pest houses, etc., but physicians of merit should 
occupy those places, and not ignorant quacks and mounte- 
banks, selected by more ignorant jDothouse politicians, and 
this is the rule rather than the exception. 

Now, what I want to say on this subject is, every pau- 
per residing several miles awaj^ from the county house, and 
in other towns in the county, should have some choice in 






Original Communications. 363 

the selection of a physician, and that this physician should 
be paid just as much for his attendance (and no more) by 
the county as if the patient was a man in good circum- 
stances and paid his own bills. But I want to especially 
denounce any physician or surgeon who will bring in an 
exhorbitant bill, because the county, city, state, or United 
States, is the rich payer. Nothing in my mind seems more 
contemptible than this tendency on the part of many men 
to squeeze the orange because it is rich ; and I am sorry to 
inform our fraternity that they are a good deal like many 
of our would-be pensioners — they want the money whether 
they really are entitled to it or not. 

Xow, my dear doctors, when you perform either medi- 
cal or surgical practice, don't be afraid to present your bills; 
don't be ashamed of your charges : don't depend upon an 
auditing board to say what you shall receive ; come out 
like gentlemen, make a reasonable charge and be able to 
sustain it by the testimony of reliable prima facie and ex- 
pert evidence. I highly disapprove of the method pursued 
by the physicians who were in attendance on our lamented 
president, in not making out a reasonable bill for services, 
and not depending upon the judgment and generosiiij of a 
congress made up of mixed politicians; they to select a 
committee of men to audit it. Xow, why couldn't Drs. 
Bliss, Agnew, Hamilton and Reyburn make out regular 
charges, and if not paid, proceed to litigate them as in 
other cases where regular charges are made and sustained ? 
But, because he was an official in high position, the bill 
was left without direct charges, hoping to receive fancy 
remuneration. It seems Dr. Bliss is to receive $6,500 for 
about seventj^-eight days' attendance, or about $83 a day ; 
Drs. Agnew and Hamilton each $5,000. or at the rate of $63 
a day, and Dr. Reyburn over $50 a daj^ and this is for every 
day from the time he received his injury until his decease ; 
and, of course, they were not in continued attendance with 
the exception of Dr. Bliss. Now I call this good pay, and 
any physician or surgeon not satisfied with it had better 
retire from the profession and let some of us try a hand, 
and not be afraid or ashamed to bring in a reasonable 
charge that could be sustained in any court of justice. 



364 The Peoria Medical Monthly. 



Electricity in Medicine and Surgery. By Geo. C. Pitzer, M. D. Professor 
of the Theory and Practice of Medicine in the American Medical College of 
St. Louis, etc., etc. First edition; 8 vo., cloth ; pp. 8.5. Price $1.00. 1883. 

The author says in the preface that "he has aimed to 
make everything as plain and simple as possible" and we 
believe he has admirably succeeded. 

The first 32 pages are taken up with a, description of 
various electrical machines in most common use, how they 
are made, how to take care of and use them. This is all 
told in a practical way and is just what a great many phy- 
sicians want to be told. 

The rest of the book is devoted to Electro-Therapeu- 
tics, and while, as a matter of course. Dr. Pitzer could not 
get very deeply into the subject in so limited a space as 50 
pages, yet we must say that what he has given will do more 
good than if his book had contained 400 or 500 pages. 

Some ten pages are quoted from Dr. R. J. Curtiss' arti- 
cles in the Peoria Medical Monthly, and due credit is 
given to Dr. Curtiss' observations and studies with elec- 
tricity. 

We have read the l)Ook with profit and heartily recom- 
mend it. 

Legal Medicine. By Charles Meymott Tidy, M. B. F. C. S., etc., etc. 8 vo ; 
cloth ; 2 vols. Wm. Wood & Co., New York. 

These two volumes close the list of the Library of Med- 
ical Authors for 1882, and wdll no doubt be heartily wel- 
comed by every subscriber to this valuable series. The 
author has collected an immense amount of interesting 
data for this work, and his arrangement will be found 
natural and easy. 

Should this series be continued the coming year, we 
predict for it a largely increased sale as every year it be- 
comes better and more valuable. 

Pamphlets and Reprints. 

Annual Report of the Supervising Surgeon General 
of the Marine-Hospital Service of the United States for 
1882. Paper ; 300-lpages. Government Printing Office, 
Washington, D. 0. 



Book Notices. 365 

Preliminary Peport on the Yellow Fever Epidemic of 
1882, in the State of Texas. From the Treasury Depart- 
ment. Paper ; 63 pp. 

Vice's Floral Guide for 1883. Illustrated ; paper ; pp 
134. Jas. Vick, Rochester, N. Y. 

The Oleates and Oleo-Palmitates in Skin Diseases. 
By J. V. Shoemaker, A. M. M. D. From Trans-Penn. State 
Med. Soc. 1882. 

The Treatment of Syphilis, with Subcutaneous Subli- 
mate Injections. By the same author. From Trans-Amer- 
ican Med. Association, 1882. 

The Therapeutic Action of Potassium Chlorate. By the 
same author. Trans-American Med. Association, 1882. 

The Philosophical Relations of Heat to Disease. By 
Romaine J. Curtiss, M. D., Joliet, 111. Reprinted from St. 
Louis Med. and Surg. Jour., Oct., 1882. pp. 12. 

Contribution to Surgical Gynecology. By Edward 
W, Jenks, M. D. L. L. D., Chicago, 111. Reprinted from the 
Transactions of the Illinois State Medical Society, 1882, be- 
ing the report of the Chairman of the Society on Gynecol- 
ogy. Paper ; pp 21. 

Modified Listerism in Ovariotomy, with a report of 
Five Recent Operations. By the same author. Reprinted 
from the Mich if/an Medical News, Dec. 1, 1882. 

Some Thoughts on Phthisis, with Special Reference to 
the Value of Laryngeal Symptoms in Diagnosis. By M. T. 
Coombs, M. D., Louisville, Ky. Reprinted from Archives of 
LarijufjoJogij, July, 1882. 

Menstrial Amblyopia. By the same author. Re- 
printed from the Medical Herald, Oct., 1882. 

Fourth Annual Report of the State Board of Health 
of Illinois. Paper : pp. 213. From the Secretary. Pub- 
lished at Springfield, 111., 1882. 

The City of Mobile (Alabama) as a Winter Resort for 
Health and Pleasure of Invalids. By W. H. Anderson, M. 
D. pp. 18. 

Report of the Board of Trustees of the Arkansas State 
Lunatic Asylum. Little Rock, Ark., Jan., 1883. pp. 14. 



366 The Peoria Medical Monthly. 



Chrysophanic Acid in the Treatment of Psoriasis. 

Anyone who has had experience in the treatment of 
this disease by the old-fashioned method witli tar ointment, 
and who employs chrysophanic acid for the first time, can- 
not fail to be struck with the almost marvelous effect of 
this drug. Yet there are many in the profession who do 
not know its value, and there are a few who doubt its 
efficacy. At a recent meeting of the New York Dermato- 
logical Society, this was made the subject of a very inter- 
esting discussion, and certain conclusions were then formu- 
lated and pretty generally agreed upon, which we consider 
of sufficient value to present to our readers : 

1. That chrysophanic acid is perhaps the most efficient 
agent known to the profession for the external treatment 
of certain cases of psoriasis, especially chronic cases which 
have resisted other methods of treatment. 

2. That its range of application is limited ; in chil- 
dren, in patients with sensitive, irritable skins, and acute 
cases, generally, it is contra-indicated. 

3. That in psoriasis affecting the face and hairy scalp, 
the intensely irritating action producing puffiness of the 
face and eyelids, and its discoloring effect upon the hair, 
render its employment impossible. 

4. That it is prompt in its action, a week or ten days' 
active treatment being usually required to develop its full 
therapeutic efficacy. 

5. That its curative effect i« only temporary ; it does 
not afford a safeguard against relapses. 

6. That it probal^ly acts only locally and by virtue of 
its irritating properties, setting up a substitute inflamma- 
tion, which modifies orcorrects the tendency to overgrowth 
of epidermic cells. 

7. That its employment is attended with certain ob- 
jectionable results, some of which always follow its use, 
while others seem to depend upon idiosyncrasy, physiologi- 
cal and morbid predispositions, etc. 

8. That a brownish, prune-juice discoloration of the 
skin which persists long after the application is discon- 
tinued, a reddish staining of the hair and nails, and an 
indelible dyeing of the clothing, are inseparable from its 
use. 

9. That the erythematous and furuncular infiamma- 
tions which occasionally follow its use may be classed as 
incidental effects, as they do not always depend upon an 



Peeiscope. 367 

excessive strength of the preparation employed, but are 
frequently manifest after a mild application ; intense der- 
matitis, resulting in exfoliation of the epidermis in large 
flakes, has been observed after an application of 10 grains 
to the ounce. 

10. That the strength of the ointment recommended 
by Balmanno Squire (2 drachms to 1 ounce) is excessive ; 
a milder strength (20 grains, 1 drachm to 1 ounce) being 
usually sufficient to develop the full therapeutical virtues 
of the drug. 

11. That in other diseases for which it has been 
recommended, as acne, favus, pityriasis versicolor, eczema 
marginatum, etc., chrysophanic acid possesses no advan- 
tages over certain other drugs which are commonly used. 

Pyrogallic acid was thought to be the best substitute 
for the other in cases where the skin was unusually sensi- 
tive, or where the disease attacked the scalp and face. 
With regard to the strength of the ointment of chryso- 
phanic acid, in our own experience we have never found it 
necessary in any case to employ a stronger application than 
one containing 10 grains to the ounce. In one case, w^iich 
we are in the habit of citing, a strong man was made alarm- 
ingly ill by the application ot an ointment of the above 
strength. The case was one of general diffuse psoriasis, 
and on the second day of the treatment he was seized with 
a rigor, his temperature rising to 105 degrees, and the body 
was found soon after to be covered with a rash identical in 
many of its characters with that of scarlet fever. This 
peculiar action of the drug was not understood at the time, 
so that sovne uneasiness was felt for the moment. The 
feverish symptoms of course rapidly subsided, and a com- 
plete cure of the psoriasis followed. Ever since we have 
preferred, especially in private practice, to feel our way, 
by commencing the treatment with an ointment not 
stronger than six grains to the ounce. One of the greatest 
objections raised against chrysophanic acid is its unfortu- 
nate property of staining the clothing. This can be obvi- 
ated in great measure by employing a species of varnish 
recommended by Dr. Fox of New York. This is made by 
suspending about 10 per cent, of the acid in flexible collo- 
dion. By rubbing up the powder first with a little alcohol 
and ether, and then adding the collodion and shaking, a 
more uniform mixture is made. Dr. Fox thinks that the 
varnish is not quite so efficacious as the ointment, but, 
after drying for ten minutes, will not stain the clothing. — 
Canada Med. and Suri/. JournaJ. 



368 The Peoria Medical Monthly. 

Chronic Alcoholism— Its Pathological Aspects. 

Excerpts from an article by CI. K. Sabine, M. D., in 
Boston Medical and Surgical Journal : 

Changes in the Skin. — In the early stages of this affec- 
tion the skin is remarkably smooth and soft, owing to an 
increase in the fatty tissue. Later on the skin Ijecomes dry 
and on the extremities hard and inelastic. 

^ The Blood. — The most striking change in the blood is 
an increase in the watery elements, and diminution in the 
fibrine. It contains much serum, forms no or only very 
small coagula, and is of a very dark color. Another pecu- 
liarity presented by the l^lood is the increase of fat. 

Fattg Tissue. — There is a marked increase in the sub- 
cutaneous fat, in the fat between the muscles about the 
different organs, especially heart, kidneys, intestine, in the 
greater and lesser omenta, in the mesenter}^, etc. In the 
later stages of alcoholism, when the digestion becomes im- 
paired and the blood deteriorated, this accumulation of fat 
disappears. According to Rokitansky there is an increase 
of fat in the marrow of the bones, the ])ony tissue at the 
same time being atrophied. 

TJie Stomach and Intestine. — A chronic catarrhal con- 
dition of the stomach is quite constant, and appears early 
in the di^^ease. This is indicated by abundant soft gray 
mucus, projections of the mucus membrane and by the 
slaty color that occurs, especially near the pylorus. Owing 
to the^disturbance of circulation wdiich takes place later in 
other organs the return of the blood from the stomach is 
interfered with so that a varicose condition of some of the 
veins is produced. The h3^pertrophy is very apt to be ac- 
companied by dilation of the glands, due to compression at 
their outlet, so that small cysts which are filled with a 
clear fluid and project from the surface result. The con- 
tinued irritation of the diseased mucous membrane is pro- 
ductive of a variety of ulcerations, from the small hemor- 
rhagic erosion, characterized by a superficial loss of sub- 
stance, to the so-called round or perforating ulcer. 

The Lirer. — The liver is the first and mcs': severely 
aflected by the abuse of alcohol of any organ in the body. 
The alcohol being taken up by the portal system is carried 
directly to this organ, and there, by its irritating effect, 
produces various disorders according to the individual's con- 
dition, and more especially the character of the alcohol. 
The more concentrated the alcohol the sooner and the 
more severely is the liver affected. Among the causes of 
fatty liver the abuse of alcohol is one of the most promi- 
nent. It is probable the alcohol acts by retarding the met- 



Periscope. 369 

amorphosis of tissue, and the blood Ijeing overcharged with 
fat deposits it in this organ. 

Interstitial Hepafifis — Cii-rJwsis of the Liver. — The most 
common cause of this form of interstitial hepatitis, which 
extends uniformh^ over the whole organ, is usually consid- 
ered to be the intemperate use of alcohol — still this is not 
necessary; most drunkards do not have a cirrhotic, but a 
fatty liver, and man}^ persons with cirrhosis are not in the 
habit of dram-drinking. 

Organs of BespiraUon. — Drunkards are very subject to 
catarrh of tbe larynx, which is often accompanied by a 
similar condition of the loharynx. This catarrhal inflam- 
mation of the larynx not unfrequently extends into the 
bronchi. A ver}^ important question is whether the habit- 
ual use of alcohol predisposes to disease of the lungs. 

Tlie Heart. — In habitual drunkards the heart is almost 
always found hypertrophied. This hypertrophy may be 
brought about in manj^ ways. As is well known the effect 
of alcohol is to increase the frequency and force of the 
pulse. Whenever a muscle is called upon to do an extra 
amount of work the effect is to increase the size of that 
muscle. 

The Vessels. — The change in the capillaries consists in 
an increase in their lumen, that of the smaller and larger 
arteries in the so called atheromatous degeneration. The 
dilation of the small vessels and passive hyperemia of all 
the organs has been explained on the ground that the alco- 
hol has a paralyzing effect upon the vaso-motor system; 
also, that the alcohol, by its irritating effect upon the walls 
of the vessels, causes a fatty degeneration of the same, and 
as a consequence a loss of tonicity. 

Affections of the Vri)ianj Organs. — After each ingestion 
of alcohol the secretion of urine is increased, and a larger 
quantity of water is excreted with it. The diseases of the 
kidneys which most frequently occur in drunkards, and es- 
pecially in the latter stages of alcoholism, are the paren- 
chymatous and interstitial or granular aephritis. The lat- 
ter is divided into two stages, that of infiltration or cellu- 
lar elements, and the othe'r of connective tissue formation. 
At first the inflamatory process produces an active hypere- 
mia, with an exudation of fluid and white blood corpuscles 
into the interstitial connective tissue. This in turn is pro- 
ductive of anemia, impaired nutrition of renal epithelium, 
and granular degeneration of the same. 

The Nervous Sijsteni. — The affections of the nervous sys- 
tem in drunkards are both numerous and important. No 
organ, with exception, perhaps, of the liver, suffers so con- 



370 The Peoria Medical Monthly. 

staiitly and from such a variety of lesions as the central 
nervous system. Many alterations in the functions are 
recognizable after death by a change in the tissues, but 
there are various affections, on the other hand, which point 
to a marked change in the cerebro-spinal system that can 
not be detected. 

Tlie Brain. — The calvarium is altered. It is increased 
in weight by hyperostosis and sclerosis, both the outer and 
inner table being thickened. The cancellated structure is 
ii;ore dense, owing to a concentric formation of bone about 
the Haversian canals. Upon the inner surface the chan- 
nels of the vessels are deeper than normal as well as the 
depressions for the pacchionian bodies. There is an in- 
crease in the amount of blood in the brain owing to the 
abnormal action of the heart and fatty or atheromatous de- 
generation of the w^alls of the small vessels, or diminished 
nutrition of the same, which paralyzes them so that their 
lumen becames increased and hyperemia results. 

Cerebral Ajjoplexf/. — An effusion of blood into the brain 
substance frequently occurs in drunkards. All conditions 
brought about by the intemperate use of alcohol which 
tend to produce cerebral hyperemia favor, in a marked de- 
gree, the occurrence of either large or capillaiy effusions. 

Serous Apoplexy. — An acute or chronic serous effusion 
into the cavity of the skull, into the brain substance, or 
into the membranes of the brain, and into the cavity of the 
arachnoid, may result from the abuse of alcohol. In alco- 
holism the blood is poor in plastic material, and as a conse- 
quence the transudation is favored. Either an acute or 
chronic collection of fluid in the ventricles of the brain is 
not an infrequent result of drunkenness. 

Pacln/})ie>ii)igifis lufenia i'hroniea. — This inflammation 
of the inner surface of the dura mater consists at first of a 
very slight layer of fibrine on the surface of the dura, from 
which a thin layer of connective tissue is afterward devel- 
oped, which adheres to the surface of the membrane. A 
second and third layer of inflammatory exudation is then 
formed, and so on until there are many layers. The dura 
matter thus becomes materially thickened. Each one of 
these la3^ers is vascular, and occasionally one of these ves- 
sels ruptures, resulting in a hemorrhage between two of 
the layers. — Louisville Med. Keics. 

Rectal Constipation. 

Dr. Benj. Lee. of Philadelphia, makes two suggestions 
(Med. Bulletin ) for the mechanical relief of this form of con- 
stipation. The first consists in applying pressure with the 



Periscope. 371 

ends of the fingers, protected if desirable by a soft cloth, 
against the most prominent point of the probulgent mass, 
throngh the rectal wall, outside of the external sphincter, to 
convert the concavity of the pouch into an inclined plane, 
over which a comparatively slight expulsive effort will 
cause the mass to glide, especially if the inner walls of the 
anus have been" anointed with some bland ointment. The 
point at which pressure usually proves most effective is just 
to the left of the sphincter posteriorly; but the finger 
passed rapidly around will readily place itself where it will 
do the most good. Patients should be taught to use this 
simple manipulation when they become conscious of the 
presence of an accumulation of the bowel which they can- 
not extrude. 

The second suggestion relates to the shape of the open- 
ing in the water closet seat. The hole of an ordinary seat 
is circular or oval in shape, and so wide as to admit a con- 
siderable portion of the fundament. As the body settles 
down the fleshy masses of the buttocks are forced together, 
thus crowding the anus and effectually preventing the open- 
ing of the sphincters. The softer and fatter the gluteal 
regions the greater will be the impediment thus produced, 
and hence the female will be the more seriously affected 
The remedy is to change the shape of the opening, by mak- 
ing its width not to exceed about one-third of the one in 
ordinary use. The upper edge should be slightly rounded 
off — not beveled. Seated firmly upon such a support, the 
nates are pushed apart rather than forced together, so that 
an impulse to evacuate will be noticeably excited, and the 
evacuation will be comparatively eas3^ requiring but little 
action of the diaphragm and abdominal muscles. 



The Best Cure for HiiJ-Joiut Disease. 

Dr. 0. H Allis, of Philadelphia, makes some practical 
remarks on this subject in the Medical Times: 

An eminent surgeon has said that nine-tenths of tlie 
cases can be perfectly cured if taken in time. Granting 
this to be true, it is clinical experience that nine-tenths of 
the cases are not brought to us in the early stage. He di- 
vides every grade of the disease under two heads. In the 
first, or milder form, the manifestations are not such as to 
occasion alarm on the part of the patient or friends. There 
is slight lameness present, and active sports, exercise, and 
vocation are precluded; finally, after months, the patient 
seeming to get neither better nor worse, the hip presents 
every evidence of recovery from hip-joint disease, but with 



372 The Peoria Medical Monthly. 

fixation of tJie Joint. In the second, or severer type, he in- 
cludes all cases coming under observation with unmistaka- 
ble evidence of high destructive inhammation. The disease 
requires the most judicious surgical care to arrest it. Slow- 
ly but steadily the symptoms subside, health returns, and 
every evidence of local disturbance disappears, when an 
examination of the joint shows y/,ra//o>?. Fixation he be- 
lieves to be nature's best cure, and the question he asks is: 
*' Can cases that have passed through the infiammatory stage of 
hip disease, in wliich the disease has been arrested and a cure 
established through fixation, be further redeemed, and a mova- 
ble joint estatAished?" Clinical teaching answers in the af- 
firuiative. His own experience is in the negative. He re- 
ports three cases in which he attempted to redeem the hip 
when nature had cured by fixation; two resulted in death, 
and the third patient escaped, but not until he had been 
dragged to the verge of the grave by established surgical 
practice. 

In the discussion that followed the reading of this pa- 
lmer, Dr. Barton entirely endorsed the position taken by the 
writer, and Dr. Willard reported three cases in which vio- 
lent and destructive inflammation had been awakened in 
long quiescent joints — in one case by an accident, in 
anotlier by the surgeon's manipulation. Should the an- 
chylosed position be one unfavorable for locomotion, he 
would practice osteotomy rather than run the risk of ex- 
citing destructive inflammation in a region where the tissues 
were uuhealthy, and where there was really no sound joint 
structure remaining. — N. Y. Med. Jour. 

Some Points ou the Reduction of Hernia. 

Seeing that the major operation, or opening of the sac, 
in a case of hernia is one that may involve great danger, 
and seeing that the minor operation, in wliich the sac is 
not opened, may involve some danger, and seeing that the 
taxiii is a safe procedure, especially when it is successful, 
any expedients that will enable the surgeon to reduce a 
greater number of hernia, so that fewer operations will be 
required, will be the means of saving life. In this state- 
ment it is implied that cases of hernia are operated on that 
do not require an operation, and it must be admitted that 
it is not good practice to operate on a hernia that can be 
reduced by taxis. 

The method of taxis for reducing a hernia, especally 
one that is strangulated, that I have adopted and advise, 
may be described as follows: 

1. As far as possible grasp the hernial tumor with one 



Periscope. 373 

hand; this can generally be readily done, except when the 
tumor is very large. The right hand will he best adapted 
for this purpose. 

2. Now take hold of the neck of the hernia sac with 
the thumb and fingers of the left hand, in close proximity 
to the ring of constricting tissues, which can generally be 
readily distinguished. 

3. Then make a gentle traction on the hernial tumor 
by means of the right hand, when two effects will gener- 
ally appear: (1) The hernia will be drawn out a little and 
liberated from the ring of constricting tissues; and (2) Some 
of the fluid contents, and may be some of the solid con- 
tents, of the sac, may be felt going through the hernial ca- 
nal into the abdominal cavity. As the hand pulls on the 
tumor, it will compress it at the same time, and thus tend 
to express the contents of the sac. And the contents of 
the sac will be more apt to be expressed because the hernia 
is liberated from its constriction. 

4. The thumb and fingers of the left hand, as it were, 
supplement the hernial canal, as the}^ are near the con- 
stricting tissues, so that the sac and its contents will be pre- 
vented from expanding just outside of the outer end of the 
hernial canal. In one instance the thumb and fingers will 
accurately guide the hernial contents into the hernial canal, 
and in the other instance the hernial contents will swell 
out around the outer end of the hernial canal. In the lat- 
ter instance the reduction of the dislocated intestine will 
be obstructed, and in the former instance its reduction will 
be greatly facilitated. 

5. When the fluid contents of the sac begin to_^o hack, 
then the solid contents of the sac will also begin to go hack. 
The left hand of the surgeon must still continue the w^ork 
it has begun, but the right hand must now, in addition to 
firmly grasping the hernal tumor, begin to push this tumor 
toward the external ring, in between the grasp of the 
thumb and fingers of the left hand, when generally, little 
by little, and sometimes suddenly, the dislocated intestine 
will be reduced. Of course, the rules of position and relax- 
ation in regard to the patient should be put in force. When 
this method of taxis is properly carried out, it wull, no 
doubt, diminish the number of operations for strangulated 
hernia. 

6. In this place I may draw attention to this method 
of taxis, for the purpose of reducing a hernia when the 
minor operation is performed, since the constriction may 
be outside the neck of the sac. Also I may call attention 
to the fact that I have sometimes expanded and stretched, 



374 The Peoria Medical Monthly. 

or, perhaps, torn more or less, the constricting band of tis- 
sues about the neck of the sac, b}^ means of my finger, 
which has been pushed up under the edge of this band, car- 
rying the tegumentary tissues before it, thus enabling me 
to reduce a hernia because the canal has been enlarged. 
At times I have found this a most valuable expedient, and 
have never known it to do any harm. 

In order to illustrate the procedure above described, two 
cases of formal hernia may be related. 

First — Mrs. S, widow, 63 years of age, was seen by me 
for the first time January 6, 1882. She had a strangulated 
femoral hernia on the left side, about as large as one's fist. 
The swelling had been down about a week; the patient had 
been vomiting for three or four days; the temperature was 
about 99 deg.; the pulse was about 100; the abdomen was 
soft and was not tender; the bowels had not moved for a 
week ; there was no special tenderness about the tumor ; 
the patient was anxious and depressed in spirits ; two days 
before I saw this patient a physician visited her, and did 
not succeed in reducing the hernia ; the patient was under 
the impression that an operation must be performed and 
that she would die. 

I saw this patient about 5 o'clock p. m., January 6. 1882, 
and put in practice the method of taxis above described, 
and reduced the hernia in about fifteen minutes ; ordered 
rest, anodynes, and a mild diet, followed in two days by a 
dose of castor oil. The patient made a rapid and excellent 
recovery. 

Second — Mrs. M., widow, 42 years of age, much ad- 
dicted to alcoholic drink, was seen first by me January 16, 
1882. She had a strangulated femoral hernia on the left 
side nearly as large as one's fist ; it had been down for 
nearly one week ; the patient had been vomiting for two 
days ; her temperature was 98A deg. ; the pulse was about 
100 ; the abdomen was soft and the furrow in the inguinal 
region was deep, as there was much adipose tissue. Her 
physician advised an operation, and was of the opinion that 
she would die without an operation. The patient declined 
an operation. 

I saw the patient about 1.30 p. m. of Januaiy 16th, and 
in about ten minutes reduced the hernia by means of the 
method of taxis, above described. In the evening the 
patient's bowels moved three times ; rest and a mild diet, 
completed the cure in a few days. 

I need not take up time by reporting other cases of 
femoral hernia of a similar kind, that I find recorded in my 
notes, nor need I mention cases of inguinal hernia, that I 



Periscope. 375 

have from time reduced by the same method — avoiding ope- 
rations, and saving life. M}^ proposition is this : Some 
cases of strangukited hernia that have been operated on 
coukl have been successfullj' treated by the above described 
method of taxis ; of course, taxis must at times fail, even 
after the minor operation, and I have seen cases where the 
reduction has been impossible after the major operation. — 
Dr. Wright, in Proceedings. 



A Study of the Action of Iron. 

The author thinks that iron has a toxic action — old 
authorities to the contrary notwithstanding ; but he says 
that the manifestations of its action are not as marked as, 
and its study is less interesting than, that of many other 
drugs, particularly those acting on the nervous system. 
Experiments were made on frogs, regarding the action of 
the metal when introduced into the veins. For many rea- 
sons, a fresh, clear solution of the tartrate of iron, neutral- 
ized with caustic potash, was thought to be best, as it 
caused no inflammation at the point of injection, and did 
not cause thrombi. A small quantity of this solution 
would kill a frog in twenty-four or forty-eight hours. It 
was equally poisonous to pigs and rabbits. There were no 
signs of thrombosis, even in the lungs. 

In order to show that it was the iron and no other con- 
stituent of the tartrate of iron that killed, a solution of the 
tartrate of soda was made. Injecting this in very much 
larger quantities than the previous solution, caused no un- 
pleasant symptoms. The animals seemed well shortly after 
receiving the iron, and the appetite remained good till a 
few hours before death, when a disposition to keep quiet 
and an apparent weakness, accompanied by frequent liquid 
stools, was observed. In a few cases there were three or 
four short convulsions, accompanied by opisthotonos, last- 
ing about ten minutes and suggesting death from asphyxia. 
The muscles and nerves reponded to electric stimulus, both 
immediately before and after death. Post-mortem examin- 
ation showed the small intestines pale and strongl}^ con- 
tracted ; the mesenteric blood-vessels were dilated ; liver 
and kidneys very much congested. The blood in both the 
arteries and veins was of a dirty claret, venous color. Ar- 
terial blood also showed the same peculiar color during life, 
which changed to nearly normal arterial color after being 
exposed to the air. 

The symptoms in cats, beginning from one to three 
days after the injection, were loss of appetite, vomiting im- 



376 The Peoria Medical Monthly. 

mediatelj^ after eating, as a rule, diarrhoea, and loss of 
weij^bt — about twenty-five per cent, in five days. In some 
cases the vomiting matters vs^ere tinged with fresh blood, 
and sometimes there were a number of dark bloody, liquid 
discharges from the bowels. The vomiting seemed only to 
come on to emiity the stomach, suggesting that the stomach 
was intolerant of, and sensitive to, the irritation caused by 
the presence of any substance — even a liquid. 

Is the death in these cases connected with the alimen- 
tary canal, where the appearances are so marked? Proba- 
bly not, as we have in some cases all the symptoms indicat- 
ing irritability of the stomach and intestines w^ithout a 
fatal result. Also this seems only to prevent the animal 
from taking food, and death from starvation will not occur 
in foitr or five days. Death probably results in some other 
way. The peculiar color of the blood suggested an exami- 
nation of it. Its certain changes.were detected under the 
microscope. The amount of carbonic acid gas w^as much 
less than normal. From this, we infer that the iron in 
some way hinders the blood from taking up the products of 
decomposition from the tissues or that the process of oxida- 
tion is incomplete. The collapse and paralysis of the cen- 
tral nervous system may be a consequence of diminished 
oxidation. This view is strengthened by the fact that the 
amount of carbonic acid in the blood was less and less the 
nearer the time of death. The action of iron is similar to 
that of arsenic and platinum. Hence we say, iron has poi- 
sonous qualities without doubt ; the symptoms of its action 
are referable chiefly to the alimentary canal, and, in fatal 
doses, it diminishes the amount of carbonic acid gas in the 
blood ; the action of iron probably resembles that of 
arsenic and platinum, and we are justified in believing that 
the action of iron on man, in excessive doses, would be 
similar to that observed on animals. 

As regards the tonic action of iron, two theories have 
been advanced to explain it : Fitsf, That its good effects 
are produced by its action on the red conpuscles. In anee- 
mia, the number of red corpuscles is less than normal, and 
after using iron they are increased. On the first theory, it 
is only necessary to sujDply a little iron in order to increase 
the number ; and as this plays an important part in the 
economy, once having a large supply, good results follow. 
Since almost every food contains iron, it would seem that 
any deficit of iron can never be very great [provided, of 
course, the appetite for food remains good.] It is not by a 
few doses of iron that its good results are obtained, but 
only after continuous use. 



Periscope. 377 

For the second theory, that iron promotes digestion, 
when we consider its action on the stomach and circula- 
tion, there is little doubt that iron has an especial action 
on the digestive organs, and particularly on those portions 
where absorption takes place, viz.: In the stomach and 
small intestine. It seems to increase the amount of blood 
sent to these parts, especially to the villi of the small in- 
testine ; and it is probable that it exercises a beneficial in- 
fluence on the process of assimilation. 

Claude Bernard says that the salts of iron have a special 
action on the mucous membrane of the stomach, and that 
all parts with which it comes in contact take on a more ac- 
tive circulation. He attributes this, however, merely to its 
acting as a local irritant. [This view is clearly untenable 
as regards the medicinal doses, as it is evident that the mu- 
cous membrane of the stomach and intestines would soon 
cease to absorb the food if kept constantly irritated — Ed.] 
Bartholow says : " Physicians are familiar with the fact 
that iron improves but little, if at all, the condition of the 
aucemic where it does not increase the desire for food and 
the ability to digest it." Arsenic is often used as a substi- 
tute for iron with good results ; but there is no arsenic in 
the red corpuscles. [Hence the increase of the red corpus- 
cles seems to be a consequence of better nutrition, as the 
author and many other authorities seem to think, as in this 
case, not only iron, but all other constituents of the cor- 
puscles are furnished. — Ed.] It may fairly be said, that in 
prescribing iron, about half a dozen of the scores of prepa- 
rations may be chosen, such as the tincture of the chloride, 
reduced iron, tartrate of iron and potash, etc., which will 
answer any indication. Trousseau and Pidoux think that 
there are many deaths in practice attributable to the ex- 
cessive administration of iron, and they insist that it is es- 
pecially dangerous in the early stages of phthisis, as tend- 
ing to promote haemoptysis. It seems, then, that iron is no 
exception to the general rule holding good for heavy 
metals, and it should not be given as a medicine incapable 
of abuse. [The rule laid down by Bartholow seems to 
strike the root of the matter, viz.: That iron is beneficial 
only when it increasas the desire for food and the ability to 
digest it. Hence, if it fails in these two things, it should 
not be given. Sometimes iron alone will fail, when, if com- 
bined with arsenic or arsenic and strychnia, it will fulfill 
both indications. — Ed] — Va. Med. Monthlij. 

The Headaches of Adolescents. 

Surgeons have long noted the relationship subsisting 
between the period of growth and that of adolescence, and 



'•378 The Peoria Medical Monthly. 

certain affectioas of the skeleton, such as deformities of 
deviation, exostoses, etc. Physicians have been equally 
cognizant of a like influence exerted during that period of 
life on the progress of acute diseases and the development 
of nervous affections. Under the latter category there ex- 
ists one affectio)! of a special nature, which has liardly 
yet received the attention which its merits. We refer 
specially to the cephalagia or obstinate headaches which 
aflects youths between the ages of eleven and sixteen, and 
which, by their intensity and the obstinacy sometimes ac- 
quired, cause them to be considered as a special entity. 
Professor Charcot, of Paris, has directed special attention 
to this subject, and Mons. Keller purposes prosecuting the 
study of these cases in a forthcoming numlier of the Arch- 
ires of Xeurolofjie. In the meantime we shall glance at the 
salient features presented by this aflection. A youth, possi- 
bly from eleven to twelve years of age, hitherto in excel- 
lent health, intelligent and acquiring knowledge with facil- 
ity, is suddenly seized with severe headache. Frequently 
they are at hrst light and transient, and do not interfere 
-with stud}^ ; soon they become more frequent, more obdur- 
ate, and ultimately compel a cessation of intellectual ap- 
plication. There is now established a chronic malad3% 
painful for the sufferer, and serious in its consequences, in- 
asmuch as it interposes a barrier to all scholastic applica- 
tion. The character of the headache is frontal. It never 
affects the posterior or lateral regions of the head. It is 
furthermore painful in the real acceptation of the term, a 
fact by which it is distinguished from other nervopathies, 
such as the cerebral paresis of adults or the ordinary neu- 
rosthenia, in which the sensations are vague and localized 
in the occipital and parietal regions. The pain is aggra- 
vated b}' mental application. When the malady is very 
pronounced the least study reacts painfully on the affected 
part. Sleep is enjoyed ; the pain is usually absent or feeble 
on awakening. Init occurs during the morning, especially if 
mental occupation is indulged in. and acquires its maxi- 
mum intensity toward evening. The affection is distin- 
guished from ordinary neuralgia in that there is no h\qDer- 
sesthesia along the nervous tracts, and from the ordinary" 
migraine in not l)eing anilateral nor propagated through 
the optic nerves, nor accompanied with sympathetic de- 
rangements of the stomach. The absence of febrile dis- 
turbances, the complete integrity of the intelligence, and 
the cure, which appears to be the rule, exclude the idea of 
any organic affection of the head. 

With respect to the etiology of the disease, in some 
cases the rheumatic diathesis may be encountered, while in 



Periscope. 379 

others this is totall}^ absent. l3oth in the patient and the 
family history : nor is an hereditary predisposition to nerv- 
ous affections always to be traced. We are thns compelled 
to seek, an explanation in the period of life through which 
the patients are passing. Thus, under the influence of 
some modification of general nutrition in connection with 
growth, the brain, owing to some given idios3^ncras3% may 
become w^eakened and painfull}' irritated. The situation 
of the joain corresponds with the portion of the brain 
especially active, as the seat of reflection and intelligence, 
during the period of adolescence*. Be that as it may. it is 
quite certain that, should this peculiar pain exist indepen- 
denth' of intellectual application, it is invariably aggrava- 
ted by it and it becomes the chief agent of the disease, and 
maintains and prolongs it. If the affection were due ex- 
clusively to a condition of growth, it should disappear with 
the progress of age. This does happen, doubtless, occa- 
sionally ; yet in other cases the affection is so persistent 
that educational pursuits have to be totalh^ abandoned for 
an indefinite period, as late in life even as the age of twen- 
ty-hve. In these days of cramming this species of head- 
ache possesses interest to parents and guardians of chil- 
dren ; and Mons. Keller assures us that no form of treat- 
ment has been so successful in his hands aa the methodical 
application of hydropathy. — Medical Press. 



Cholera and Filtli in Calcutta. 

An interesting article in the Indian Med. Gazette (Sep- 
tember), on the relation between cholera and filth, as ob- 
served in Calcutta, in which this is shown by tabular 
statements, terminates in the following words: "The close 
association of cholera and filth in Calcutta was very vividly 
demonstrated by Dr. Pa3'ne in the able and instructive re- 
ports wiiich he prepared during his tenure of office as 
Health Officer of Calcutta. As a result of special inquiry 
he was able to affirm that a large majority of cholera seiz- 
ures in Calcutta occurred in the vicinity of foul tanks and 
wells, where w^ater afforded an easy medium or nidus of con- 
veyance or development of the cholera poison. Evidence 
of the same sort has been forthcoming in later years, and 
a ver}^ remarkable instance of the outbreak of cholera in 
consequence of the fouling of air and w^ater was recorded. 
The lesson which these facts convey is, that, wdiatever the 
specific cause of cholera may be, the dependence of the 
disease on filth elevates the practice of general sanitation 
into the position of a special prophylactic of this dire and 
deadly disease. — Med. Times and Gazette. 



THIH 



Peoria Medical Monthly. 



THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jefferson Street, .* . . . PEORIA, ILL. 

*** All exchanges, books for review, and communications must be addressed to the 
Editor and Publisher. 

***The publication day of this joiu'nal is on or about the 1.5th of each month 
»*,To subscribers I A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



C^tlitorial §t\)nv\n\tni. 



Xotes and Comments. 

Dr. J. Forsyth Meigs, of Philadelphia, died from pneu- 
monia in December. 

The Louisville Medical News is enlarged to sixteen 
pages weekly, and has a new outside dress. 

The North Central Medical Society, of which he was a 
member, passed suitable resolutions on his demise. 

Dr. Forbes, Demonstrator of Anatomy in Jefferson Med- 
ical College, was held to bail on eight indictments for grave 
robbing. 

The Maryland Medical Journal has a newly appointed 
editorial staff of fifteen members. Dr. Ashley remains at 
the head. 

The Missouri Valley Medical Monthly has been changed 
to the St. Joseph Medical Herald, and the price reduced to 
$1.00 a year. 

Sir Thomas Watson, author of "The Principles and 
Practice of Medicine,'' died during December, at the ad- 
vanced age of 91 years. 

By a grievous oversight, on our part, a paper by Dr. C. 
H. Carter, of Chicago, has been omitted from the present 
number of the Monthly. It will appear in the February 
number, and will be found interesting reading. 



Editorial Department. 381 

Dr. Nance, of Kewanee, reports an interesting case, 
where a soft rubber catheter escaped into the bladder. It 
will appear in our February number. 

Among the various New Tear's presents received by 
Dr. W. E. Guthrie was a fat girl, from his wife. Dr. G. has 
our sympathies in his future experience at nursing. 

Widow woman (to chemist, who was weighing a grain 
ot calomel in dispensing a prescription to her sick child) : 
''Man, ye need na be sae scrimy wi't — 'tis for a puir father- 
less bairn !" 

If you do not get the charts immediately after sending 
us your subscription, do not get mad at us, for they will be 
sent to you as soon as possible. It is hard to keep up with 
the demand. 

Dr. Albert Reynolds, of El Paso, died at his home Dec. 
1, 1882. Dr. R. was one of the oldest practitioners in 
Woodford County, and his death is mourned by a large cir- 
cle of friends. 

The New York Medical Journal appears as a weekly. 
Under the able editorial management of Dr. Foster it has 
attained a high rank among the high priced eastern jour- 
nals, and deserves it. 

This is a good time to write for your journals. Long 
winter evenings cannot better be spent than in contributing 
your share to the general fund of information. Send your 
manuscript to us, please ! 

The Virginia Med. Monthly is getting credit for an arti- 
cle written for the Peoria Medical Monthly, by Dr. W. A. 
Byrd, on the stomach tube in some of the convulsions of 
childhood. Play fair, Brother Edwards. 

Dr. Squibb in his Ephemeris says, "St. Jacobs Oil" ap- 
pears to be a feeble and badly made aconite liniment, and 
it consists mainly of water, alcohol, turpentine and a small 
proportion of aconite with red coloring matter." 

The Women's Medical College, of Chicago, is in a most 
prosperous condition. With nearly 100 students in attend- 
ance this year the building is found to be to small, and will 
probably be enlarged to meet the increase in classes. 



382 The Peoria Medical Monthly. 

It is not too late to wi.sh each of our readers a '' Happy- 
New Year." Neither is it too hite to ask each one who is 
not a subscriber to become one. Our subscription list is 
growing faster than ever before, which shows our efforts to 
please are appreciated. 

Dr. Ranch, Secretary of the Illinois State Board of 
Health, has unearthed a barber, who, by assuming a dead 
doctor s name and diploma, obtained a certificate to prac- 
tice. His name is Lambrecht, and the assumed name is 
Dr. Henry A. Lueders. Pass him around. 

The following are the officers elect of the North Cen- 
tral Medical Society (111.) for the ensuing year: President, 
Dr. J. M. Cowan ; Vice President, Dr. Gr. Newkirk ; Secretary 
and Treasurer, Dr. F. Cole. The next meeting will be held 
at Wenona, 111., the first Tuesday in December, 1883. 

Subscribers who have not sent in their renewals will 
find a renewal blank and envelope in this number, for their 
immediate use. Some owe for two years' subscription. 
Will you attend to this matter at once, as we wish to have 
our books square for the coming year ? Do not neglect 
this. 

The Micliiyan Medical News and the Detroit Clinic have 
been united under the name of the Medical Age, which will 
appear bi-monthly. We are glad to note that Dr. Mulheron 
has been retained as editor-in-chief. His sprightly pen 
would be greatly missed in medical journalism should he 
retire ; his associate editors are gentlemen of experience in 
the business and we predict success for the Age. 

On the twenty-first anniversary of his arrival amongst 
them, the people of Fairview, 111., gave Dr. S. B. Bennett a 
good old fashioned surprise party. This is as it ought to 
be. When a man has spent twenty-one years of his life, 
laboring for the welfare of a community, it is very pleasant 
to have such evidence that his work has been appreciated. 
We would be pleased to hear of many more such surj^rises 
in other places, as it would show that the doctor is recog- 
nized as a social factor, and not considered, as is too often 
the case, a mere necessity. Dr. Bennett has our heart}^ con- 
gratulation, and we hope his life may long be spared to 
care for the health of the good people of Fairview. 



Editorial Department. 38^' 

Dr. Hollmau [Nedrel Weekbl., IS, p. 272J reports the 
case of an old man aged SO, suffering from retention of 
urine, in whom the introduction of a catlieter failed to pro- 
duce the desired result. It was found that the bladder con- 
tained coagulated albuminoid masses mixed with blood. A 
few hours after the injection of about sixteen grains of Dr. 
Jansen's pepsine dissolved in water, a large amount of dark, 
vascid fetid fluid readily escaped by the bladder. — London 
Med. Becord. 

Somebody connected with the Medico-Literanj Journalj. 
of San Francisco, is mad, as witness the following from the 
December number: 

It the man that is circulating the report that we have 
grown discouraged, and have stopped our work in the Wo- 
men's Zvledical College, does not grow discouraged himself, 
and stop telling that falsehood, we would advise him to 
put an iron pot upon his head, as Brooks in the Senate 
Chamber advised Sumner to do just before the War of the 
Rebellion, to protect his skull while Brooks enforced his ar- 
gument with his cane. 

Dr. Squibb is squelched ! This is how : Dr. J. V. Shoe- 
maker wrote a paper on oleates in skin diseases, Dr. Squibb 
criticised it, and now Dr. Shoemaker rejoins that although 
Dr. Squibb has a greater reputation as a chemist than he 
can claim, still Dr. Sq. is not a practitioner, while he. Dr. 
Sh., is, and he. Dr. Sh., "must certainly expect Dr. Sq. to 
first devote some time to the study and practice of thera- 
peutics before he can consider epiieineral therapeutic erup- 
tions as worthy of credence by the medical profession." 
Good bye. Dr. Squibb ! By the way, who is Dr. Shoemaker ? 

Dr. H. L. Tanney relates a very interesting case in the 
.Nashville Jour, of Med. and Surg. The doctor w^as sum- 
moned hastily one night to a lady who had been under the 
treatment of a hom<Deopath for a retroverted uterus. He 
found the patient suffering intense pain, and u^dou examin- 
ation discovered a large-sized Hodge pessary skillfully 
lodged in the rectum. This reminds us of a case, related 
by Dr. Byford, where a Hodge pessary was introduced in the 
bladder by a rather nervous gentleman in his first case of 
gynecology. 



384 The Peoria Medical Monthly. 

Boracic acid is found difficult to reduce to a fine pow- 
der. The Druggists' Circular recommends the following 
method as being satisfactory : Warm a Wedgewood mortar 
by pouring into it a little alcohol and setting fire to it, then 
put into the warm mortar the acid with a few drops of 
glycerin, when it will be easily reduced to a fine powder. 

In the American Homoeopathic Pharmacopeia, for the 
year 1882, published by Boeericke & Tafel, New York, the 
following names are found indicating the diseases from 
which the pus or poison is taken to manufacture the 
homoeopathic medicines ; Psorin, anthracin, glanderin, gon- 
orrhin, leucorrhin, sypilenum, buboinum. — Pacific Med. and 
Surg. Jour. 

Receipts for December. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card: 

Illinois— Drs. H. M. Sabin, E. R. Lovesee, Norris & Gebliart, J. C. Smiley, 
T. J. Rich, E. Bolls, Sum'l Lance, P. McElvaiu, B. F. .Johnson, W. A. Thompson, 
J. H. Thompson, H. J. Rice, .T. Lee, H. .Judd. J. P. McClanahan, A. H. Kinnear, 
V. F. Potter, H. A. Raney, Warren Hunter (2 years), A. M. Lee, J. H. Maxwell, 
A. E. Gibbs, F. Potts, C. B. Maclay, C. Truesdale, S. M. Barnes, D. D. Grier (2 
years), C. C. Sprague, E. O. F. Roler, M. A. McClelland, N. F. Felker, A. M. Bird, 
W. D. Nelson, J. F. McAnally', W. S. Higgins, John Alsop, F. C. Gay, A. A. 
Wolfe, .J. L. Hoover, R. ,J. Curtiss, J. H. Ranch, John Wright, J. M. Ausley, J. O. 
Everett, W. L. Kreider, E. Schwartz, Z. H. Going, J. H. McGhee, I. H. Reeder, 
P. C. Clayberg, W. D. Earns, J. I. Skelly, W. Zindel, W. H. AVeirich, G. W. Re- 
mage, • Wills, F. P. Anthony, H. Reader, Green Hill, A. F. Hand, A. D'Arcourt, 
M. C. Keith, P. T. Leeds, Wm. A.James. 

Iowa— Drs. O. Harris, Ira Bates, G. A. Moulton, R. M. Dewitt, J. D. Henry, 
M. B. Cochran, C. S. Shepherd, F. P. Batchelder, G. A. Stuart (2 years), H. W.' 
Hart. 

Kansas — Drs. O. M. Dotson, B. Dailey, G. W. Robinson, J. Lewis. 

Nebr.^ska— Drs. W. M. Line, J. Z. Hill. 

Missouri — Drs. W. H. Otis, N. B. Jones. 

Minnesota — Dr. E. C. Putnam. 

Wisconsin— Drs. G. ^V. Harrison, H. Hannum, H. A. Wolter, W. H. Earles. 

Indiana — Dr. J. D. Ebert. 

Alabama— Drs. G. S. Macon, P. M. Bruner. 

Arkansas— Drs. L. C. White, P. S. Woodward. 

Florida— Dr. S. N. Bixby. 



The Peoria 
MEDICAL MONTHLY. 



Vol. III. FEBRLARY, 1883. Xo. 10. 



(!)ri9iual tfommuuiratious. 



Art. I. — Clironio Gastric Ulcer. By Robert Roskotex, M. D., Peoria. Read 
before the Dickinson Club. 

If we exclude the ulcerations in the v^arious forms of 
carcinoma, or those resulting from lesions by chemical or 
mechanical injuries, we still find a rariety of others, of 
w^hich the so-called simple or round ulcer of the stomach. 
is the most important. The many sj-non^^ms by which it 
is known are intended to denote respectively the form, 
character, cause, course and issue of the same. Hence it 
is called the round, the corrosive, the digestive, the perfo- 
rating and the chronic ulcer, although the latter term is 
entitled only to a limited application. 

The continued action of the gastric juice (often changed 
in its chemical composition) upon the tissues of the stomacli 
during the agony of death and after its occurrence is sa 
potent, that it is very difficult to decide which of the anat- 
omical changes were present during life and which only 
took place after death. It is in part lor this reason, that 
we scarcely ever find an opportunity to study the round 
gastric ulcer from its beginning. 

The main feature of the ulcer is that it is not attended 
with inflammation of the rest of the stomach. Its form is 
round or oval unless several ulcers become confluent when 
the edges present a more ragged appearance. Sometimes 
there is but one single ulcer with hard reversed edges, not 



386 The Peoria Medical Monthly. 

inclined to perforate, or one or more funnel-shaped ulcers^ 
often in groups of three or four, with a strong tendency to 
perforate. The bottom of the ulcer is of a greyish color, 
the tumefied edges are rose-red or livid and always strong- 
ly injected. Their favorite seat is in the pyloric re- 
gion near the minor curvature, most frequently in the 
posterior wall of the stomach, while the less dangerous fol- 
licular ulcers may occur at any place of the stomach, in the 
fundus as well as the pjdoric region. 

According to their stage or duration we notice ulcers 
involving only the mucous membrane, usually with sharp 
edges, others already farther advanced with destruction of 
the vascular and muscular coat and in extreme cases with 
perforation of the peritoneum. The size of these ulcers 
varies from that of a pea (and even smaller, especially so 
when there are several of them grouped together), to that 
of a silver quarter. In its progress it becomes funnel-shaped 
in such a manner that the diameter of the ulcer diminishes 
with the depth to which it extends. 

If the peritoneum is perforated the contents of the 
stomach will enter the abdominal cavity unless adhesions 
with other organs are timely established, when the tissues 
of the latter will fill up the hole and gradually assume a 
character similar to that of the destroyed mucous mem- 
brane. In other cases the ulceration extends into these pa- 
thologically attached parts, for instance into the liver. An 
opening communicating with the transverse colon, causing 
vomiting of feculent matter has been repeatedly observed. 
B}^ the erosion of the capillaries, hemorrhage of the stom- 
ach is of frequent occurrence. The extravasated blood 
causes emesis or it is removed by way of the bowels. When 
an artery or vein of a large caliber is eroded, then the stom- 
ach may be filled with blood so rapidly that death often 
ensues without previous vomiting. 

Cicatrices of ulcers of a stellate form are often observed ; 
when large they may cause strictures and other deformities, 
of the stomach. Being unable to follow the peristaltic 
motion of the latter during digestion the}' are torn and lia- 
ble to break open, thus causing the frequent relapses of the 
ulcer. 



Original Communications. 387 

There exists a gastric ulcer which materially differs 
from the fuunel-shaped form. We hardly ever see it in its 
first stage and only notice it after it has run its course and 
formed a round aperture with sharp edges, looking as if 
punched by an instrument, uniformly penetrating all mem- 
branes to the same extent. This ulcer has also been no- 
ticed in the lower region of the oesophagus and in the up- 
per or horizontal part of the duodenum mostly close to the 
phylorus. 

The causes of these gastric ulcers are still veiled in 
some mystery. Among the many theories the following- 
are the most plausible : 

1. Embolism and thrombosis of branches of vessels 
supplying the stomach. 

2. Extravasation of blood into the tissues of a limited 
space of the mucous and submucous tunic. 

3. The action of an hyperacid gastric juice upon the 
tissues, causing self-digestion. 

4. Want of proper vitality. 

Though it is true that experiments on animals have 
demonstrated that ulcers of the stomach may be produced 
by artificial embolism, yet emboli are not often found in the 
gastric arteries, and if so it remains still undecided whether 
the emboli or thrombi found in the arteries and correspond- 
ing veins are not rather the consequence than the cause of 
the ulcer. 

The theory that self-digestion is prevented during life 
by the constant flow of alkaline blood in the capillary net- 
work of the gastric mucous membrane is very plausible and 
supported by many authorities. The ulcer, therefore, re- 
quires an antecedent stasis for its production. The fre- 
quencj^ of these ulcers in chlorosis and anaemia seems to 
corroborate this theory since the impoverished blood im- 
pairs the healthy state of the blood-vessels and the circu- 
lation as a consequence. The causes just enumerated 
coupled with excessive acidity of the gastric juice may per- 
haps account for the fact that enfeebled females are ofteuer 
affected with gastric ulcers than males. The gastric juice 
exercises the same dissolving effect upon parts of lost or 
diminished vitality as upon other digestible matter. 



The Peoria Medical Monthly. 

The origin of the funnel-shaped ulcer is explained by 
an hemorrhagic infiltration into a circumscribed area of the 
layers of the gastric walls. The entering branches of the 
arteries run parallel with each other in the deeper tissues, 
but in the mucous membrane they spread out, forming a 
dense net-work presenting a layer zone and very naturally 
the diameter of the infarct would be larger in the mucous 
tunic than in the deeper tissues. Another element is that 
by the contraction of the muscular fibres, in consequence 
of the irritation, a smaller surface and a greater resistance 
is ofiered. 

The round ulcer with sharp edges, forming an aper- 
ture equally large through all the tunics, is also known by 
the name "Spontaneous circumscribed perforation of the 
stomach." Its course is hyperacute. Persons who died of 
this perforation were often perfectly healthy up to the mo- 
ment when it occurred. The balance of the gastric mem- 
branes were found in a perfectly healthy state, but in some 
instances impressions were seen close to the round opening 
similar to those made by the finger in some oedematous part. 
They are caused by the destruction of the mucous and submu- 
cous membrane and would eventually have resulted in other 
perforations. The nature of the spontaneous circumscribed 
perforation, alias ulcer, consists in a rapid destruction of 
the whole gastric parieties in single points, caused by an 
aflection of the dorsal part of the spinal cord, which may 
have existed for some time, or which has suddenly devel- 
oped ; this spinal affection may also simultaneously with 
the perforation result in softening without a premonitory 
symptom. Such patients feel sometimes a vivid sting in 
their back and give a start as suddenly as if struck by light- 
ning. Romberg called this the eccentric action in the or- 
ganic sphere. Some fibres of the sympathetic nerve enter 
the spinal chord and the brain, others pass along the blood- 
vessels ; every lesion of the sympathetic nerve may, there- 
fore, manifest itself in its distribiftion. The possibility of 
this origin or the disease is based upon the intimate con- 
nection of the cerebro-spinal system with the sympathetic 
nerve. A disturbance in the centres can manifest itself in 



Original Communications. 

three directions, namely : towards the motoric sphere 
shown as convulsions, towards the sensitive sphere as in- 
dicated by neuralgia, and towards the trophic sphere as 
decay. The eccentric changes in their extent and intensity 
are generally proportionate to the fundamental lesion. A 
slight irritation of the spinal chord by concussion easily 
causes diarrhoea. In cholera the abdominal organs will 
readily respond to the severe affection of the spine, but in 
other cases the lesion in the centre is only slightly marked 
while the perforation of the stomach has already taken 
place and vice versa. The relation between the dorsal part 
of the medulla and the stomach and small intestines is very 
intimate. If the lesion of the spine is so severe as to result 
in softening, the stomach will rapidly show the same pro- 
cess. 

The exciting causes of the chronic ulcers are unknown. 
The use of irritating or indigestible food, the abuse of alco- 
holic drinks, of very hot or cold meals have formerlv been 
considered as causes, but this assertion could not be sus- 
tained by practical observation. 

Symptoms. — There is a permanent burning and gnaw- 
ing pain, shooting backwards, which becomes more intense 
after every meal and continues for hours until the chyme 
has passed the pylorus, or. what is more common, until 
emesis supervenes and a ver}^ acid chyme, often mixed with 
bloody mucus is vomited. The epigastric region is very 
tender to pressure, the pain mostly limited to a small spot. 
Vomiting occurs ver\^ frequently, and mostly after a meal. 
The bowels in a great majority of cases are constipated. 
Aneemic young girls are more subject to the ]3erfo rating 
ulcer. 

The ailment may be mistaken for cancer, but the his- 
tory of the case, the characteristic aspect of the patient and 
many other points, which space will not permit me to name, 
make a differential diagnosis not difficult. The sjanptoms 
of chronic gastritis and of chronic ulcer are similar, but in 
chronic gastritis we find no hemorrhages and the pain is 
considerably less. In gastralgia the pain is not increased 
during digestion and the pain in the epigastrium is 



390 The Peoria Medical Monthly. 

wanting. Hsematemesis may also accompany morbid pro- 
cesses in other organs, f. i. congestion in the portal system 
generally, bnt the consideration of the changes in these 
parts will enable us to determine the cause of the hagmat- 
emesis. 

Prognosis. — Although the existence of the chronic gas- 
tric ulcer always seriously imperils the life of a patient, 
still under a judicious treatment and diet many cases have 
recovered. iVs a rule the frequent hemorrhages and the 
want of nutrition, if not relieved, will eventually under- 
mine the vital energies. Perforation proves fatal unless 
adhesions were previously formed. Strictures of the stom- 
ach formed by cicatrices are a source of pain and often give 
rise to a relapse of the ulcer. 

Treatwent. — Perfect rest, physically and mentally. Care 
in the selection of food is of supreme importance ; it must 
be light but nutritious and always administered in a liquid 
form in small rations ; half a tablespoon to a tablespoonful 
at short intervals. If the stomach rejects everything we 
have to resort to rectal alimentation. It is very important 
that the strength of the system be sustained, since we know 
what a deleterious influence a bad state of health exercises 
upon wounds and ulcers in other parts. The gastralgic 
trouble can be ])est allayed by morphine. Belladonna, hy- 
oscyamus and bismuth are not so effective. It is not 
always advisable to arrest the emesis, by which the surplus 
of morbid gastric juice is ejected, but if it becomes too vi- 
olent, small pieces of ice and hydrocyanic acid may be 
used. In extreme cases the medicines indicated are to be 
introduced by the rectum. Hemorrhages of the stomach 
are to be arrested by the use of ice internally and by its 
application to the epigastrium. Sugar of lead, or alum are 
often successful. Ergot will not be tolerated by the stom- 
ach and must be added to an enema. 

The patients have to observe a strict diet for a long 
time to prevent relapses. The consecutive anaemia is to 
be treated according to general rules, though preparations 
of iron are dangerous in this ailment and, therefore, should 
be used with great caution. 



Original Communications. 391 

Art. II.— The Screw Fly and Its Ravages. By Joshua Richardson, M. D., 
Moravia, Iowa. 

This is the common name of the Sarcophaga Georgine^ 
(so far as I have been able to determine), a carrion or blow 
fly that infests the southwestern portion of the United 
States, Mexico, and also Central and South America, where- 
ever the climate approaches the tropical in character. It 
is wholly unknown in more northern regions, unless for a 
brief period in midsummer, when it may reach so far north 
as Nebraska and east to the Missouri and Mississippi rivers. 
While the common blow fly deposits its eggs, with rare ex- 
ceptions, in dead or ulcerated animal matter, the screw fly^ 
to which it is closely related, seems especially attracted by 
effluvia ; as the foul odors from ulcers, etc. Flying to the 
afi'ected part, it deposits eggs, which in a few houis, or days 
at most, hatch out into the larvae or grubs. These at once 
begin their work, not only destroying the diseased parts, 
but the healthy neighboring textures as well. Their num- 
ber is so great, that once located in a cavity as the nose 
(their most dangerous seat) they rapidly destroy everything 
in their way except' bone. Hence the danger to persons af- 
flicted with offensive catarrhs living in regions infested by 
them. 

The fly will deposit from 200 to 300 eggs, and the larvas 
when hatched being aiost voracious and incessant eaters 
will attain their full size in a few days, measuring three- 
fourths of an inch in length and from li to 2 lines in di- 
ameter. Their color is white until the chrysalis state be- 
gins when they change to a brown and drop away to fall 
into the earth, where they lie until matured into a fly. 

Death may be caused by destruction of the part at- 
tacked and the irritation resulting from it — traumatic ery- 
sipelas — animal poison conveyed from the object last fed 
upon — from the larvae working their way interior cavities, 
causing the formation ol abscesses, or a combination of 
two or more of the causes just mentioned. 

It being a fly peculiar to warm and tropical climates 
alone, attacks from it are unknown in northern regions. 
But few physicians or surgeons as a consequence in these 
localities are at all familiar with its treatment or history ; 



392 The Peoria Medical Monthly. 

hence the following may be of interest to others practicing 
in the north as it certainly was to me. 

While traveling in Kansas the latter part of last 
August a citizen of this place had the misfortune to receive 
while asleep a deposit of eggs from this fly. He had been 
troubled for years with ozoena, hence the attraction to the 
fly. He returned home a few days after the accident and 
shortly after began complaining of a bad cold. 

Growing rapidly worse I was called to attend him. 
Monday, my first day, his appearance was that of a man 
laboring under a severe cold. Had slight congestion ot the 
lungs and moderate grade of fever. His nose seemed 
greatly swollen and he complained of a smarting uneasy 
feeling in it, and general misery through the head. Clave 
Mm treatment to relieve the congestion and fever and left 
with the promise of calling the next day, as I did not feel 
altogether easy over the symptoms presented. Tuesday 
saw him again. His nose and face were still more swollen 
and in addition to the other symptoms he was becoming 
slightly delirious and complained a great deal of the in- 
tense misery and annoyance in his nose and head. A few 
hours after was sent for ii- haste with the word that some- 
thing was in his nose. I found on examination a mass of 
the larvas of this fly (or ''screw worais" as they are com- 
monly called in the South) completely blocking up one 
nostril. On touching them they would instantly retreat 
en mass up the nostril. Extracted a few but soon found 
that to get them away rapidly something better than for- 
ceps must be employed. Taking a tew to my oflice I began 
experimenting until I found that chloroform would as soon 
as injected on them kill them instantly. Making a 20 per 
cent, solution of it in sweet milk T made a few injections 
up both nostrils, which immediately brought away a large 
number, so that in a few hours I had taken away some 125 
of them. Realizing the danger to him from erysipelas 
setting in, as indeed some premonitory symptoms of it had 
already appeared in and about the nose and face, I put him 
at once on tr. per chlor. iron and quinine, as also a solution 
of sulph. iron in glycerine as a topical application. By 



Original Communications. 39B 

Wednesday eveniDg erysipelas had begun, implicating the 
nose and neighboring portions of the face. 

Tuesday morning at my request another physician was 
sent for. 

Dr. Sawyers, jr., of Unionville, came in response in the 
afternoon. 

By continued syringing with a strong antiseptic solu- 
tion of the salycil-soda, bicarb-soda, and carbolic acid we 
hoped to drown them out. But they had by this time cut 
their way into so many recesses of the nose and were so 
firmly attached that we were unable to accomplish much. 

Finally we resorted to the chloroform injections which 
immediatel}' brought away a considerable number. 

Friday I was able to open up two or three canals that 
they had cut, extracting several more that had literally 
packed themselves one after the other in these fistulous 
channels. 

His speech which had been getting very much ob- 
structed since the day before, becoming suddenly much 
worse, I examined the interior of his mouth and found that 
a clear cut opening had been made entirely through the 
soft palate into his mouth, and large enough to insert the 
end of a common lead pencil. Saturday the few remain- 
ing began changing color and one by one dropped away. 
On Sunday for the first time heeniorrhage from both nos- 
trils took place, which continued at intervals for three days, 
but was not at any time very severe. On this day (Sun- 
day) his condition began to improve, the delirium and 
erysipelas having subsided, leaving but little or no annoy- 
ance in his head. 

Our hopes for his recovery, however, were doomed to 
disappointment. 

In a few days he became able to go about home and 
even to walk a distance of half a mile to visit a friend and 
return. But while there he began complaining of a pain 
in the neighborhood of his left ear, apparently where the 
eustachian tube connects with the middle ear. 

It proved to be an abcess ; but situated where it was I 
did not deem it prudent to push a lance, as I would have 



394 The Peoria Medical Monthly. 

been compelled to do, directly in the course of the eusta- 
chian tube, juo^ular vein and carotid artery. 

Being already so reduced by the first attack he was un- 
able to withstand the second, and died after an illness of 
near three weeks, completely exhausted by his prolonged 
sufferings. Three days before his death the abcess dis- 
charged its contents by the left nostril. The quantity of 
IDus formed was about 24 ounces. 

In all about 250 larvae were gotten away from him 
during the first attack, and as the visible results, not only 
had they cut the hole through the soft palate as referred 
to, but had also eaten the cartilage of the septum of the 
nose so nearly through as to give him the appearance of 
having a broken nose. The case occupied from the first in- 
vasion of the fly until its final result near two months. 

He doubtless would have recovered but for the forma- 
tion of the abcess, which, from all the symptoms, present- 
ed was caused by one or more of the larvae having found 
their way up the left eustachian tube. Throughout the 
second attack the misery was exclusively confined to the 
one locality, the space just unde)' and behind the left 
condyle of the lower jaw, and radiating from thence to the 
ear and side of face, ^o post mortem was allowed. 

The Rev. William Dixon, of Green, Clay Co., Kansas, 
gives in substance the following account of himself : 

While riding in his buggy a few years ago in Texas, a 
screw fly attacked him, flying up one nostril. He blew it 
out when it then dashed up the other and deposited its 
eggs before he was able to expel it. Not realizing the dan- 
ger he did nothing for about three days, when the pain be- 
came so great that he hastened to Austin to consult a phy- 
sician. His soft palate was almost destroyed before the 
larvae, over 200 in number, were expelled. 

I have heard of ten other cases, all of whom died ; so 
that oat of twelve cases but one recovered. 

Not knowing the treatment pursued where it is known, 
will give that which I should employ in a similar case. As 
soon as discovered, especially if it be the nose attacked, no 
time should be lost ; as the eggs hatch in a few hours and 
the larvae eat constantly until matured ; so that in a few 



Original Communications. 395 

days the work of destruction is complei-e, if not removed. 
Frequent injections up both nostrils, with a 15 or 20 per 
cent, solution of chloroform in sweet milk should be made, 
the patient, while the injections are in progress, opening- 
wide his mouth, and leaning w^ell forward, so as to prevent 
the injection being swallowed. Even stronger percentages 
of the chloroform may be used, as its admixture with the 
milk causes but little irritation. A pair of slightly curved 
forceps, and (if nothing Ijetter) a common hand mirror, for 
reflecting the light up the nostrils are to be employed, for 
extracting the weakened larvse after the chloroform has 
been injected on them. The patient should also be put 
upon treatment for erysipelas, even though it has not ap- 
peared, as by so doing it may be prevented or at least 
abridged. 

As soon as they begin to take on a brown appearance, 
which occurs as soon as they have attained their full size, 
they drop away and seek the earth to go through the 
chrysalis stage before developing as flies. Hence active 
treatment may cease at this time, as they eat no longer af- 
ter attaining this stage of their development. Attempting 
their removal by the forceps alone involves too much time 
for the safety of the patient : in fact in the nose it would 
be impossible with the forceps to reach them all. Long 
continued syringing wdll, 1 think, do more harm than good 
unless it contains something fatal to the larvae. 

In mj case a strong antiseptic solution was used, but 
which w^as powerless to weaken them to any great extent. 
We applied it almost incessantly, for at least 2-| hours, 
with the only effect of bringing away a few. 

Just before making the chloroform injections (or any 
other that tends to quickly kill them) it w^ould be advisa- 
ble to give the nose a good sj^ringiug with an antiseptic. 
in order to cleanse it as much of the stenc has possible. If 
hemorrhage should take place at any time, as there is con- 
stant danger from them tapping an artery or vein make 
plugging the noses the last resort ; for by so doing we 
would cut ourselves off from our work. As regards the 
treatment when in other cavities, the physician must be 
guided by the location of the part attacked. 



396 The Peoria Medical Monthly. 

Art III —Look Out for Your Soft Catheters. By Hiram Nance, M. D., Ke- 

wanee, 111 

On the Sth of January I was telegraphed to from Cam- 
bridge, the county seat of Henry county, distance twenty 
miles, to visit an old acquaintance of mine. R. D. K — , Esq. 
In the telegram it was stated, "Come, I am afflicted with 
kidney and bladder disease." I immediately prepared to 
go, not forgetting to slip in my pocket a medium sized 
Jaques catheter. I arrived at the house about 4 p. m. and 
as soon as possible proceeded to examine my patient and 
found he had been under the care of one of our little pill 
fraternity for eight or ten days, or perhaps a longer period. 
Mr. K. was aged about 64, the period so common for pros- 
tatitis to make its appearance, but it seems that hommo- 
pathy had not suspected any mechanical cause for the re- 
tention of the urine, which had partially existed since his 
attack. The patient was suffering terribly, and was taking 
both hoiiKDeopathic medicine and morphine in one-eighth 
grain doses to relieve him. Finding him in a very free 
state of perspiration, partially stupid, and a strong urin- 
ous smell on raising the bed clothes, and on examining the 
pubic region it was fully distended, and a continuous stili- 
cidium of urine, I determined at once to introduce a 
soft catheter, and on doing so, without any pain, I drew off 
nearly three pints of dark colored urine. Had this urine 
been permitted to remain only two or three days longer 
you all know that he would have died with poison pro- 
duced from the affects of the absorption of urine, or more 
properly uremia. 

I suspected the cause of the retention before the intro- 
duction of the catheter, and called the nurse to the bedside 
to show him how to manipulate the instrument, for I pre- 
sumed on a continuance of the operation for a long time. 
After prescribing and indulging in a splendid supper, on 
the next to the coldest night of the season, -I bade good by, 
feeling happy over the great relief I had been able to give 
my patient, and feeling confident that the nurse would be 
able to relieve him with the soft catheter three or four 
times a day. Imagine my surprise in just twenty-four 
hours (9 o'clock p. m.) I received a telegram from the Rev. 



Original Communications. 397 

George K — , his son, stating : "Come immediately. Ca- 
theter slipped in the bladder." I was horror stricken. I 

was twenty miles aw^ay from patient ; Saturday night ; no 
telegraph or trains at the hour, nor w^ould be until Mon- 
day ; no alternative but to go ; mercury near zero ; snow- 
ing from the west like the deuce, and pouring in our faces. 
I called in Dr. Nichols, of this place, and solicited his com- 
pany and advice. We started in the blizzard and arrived 
at the house at 1.30 a. m. Sunday. On examination we 
found the catheter entirely out ot sight. They had called 
in a physician who refused to do anything, saying it would 
probably require an operation, and as the case was not his 
he w^ent home. 

Visions of lithotomy and lithotripsy flitted hurriedly 
across my mind ; also, the careful introduction of a fine 
pair of forceps, a hooked wire, stream of water introduced 
through urethra by syringe, hoping a counter current 
might expel the intruder. But none of these were tried.. 
We, by feeling the urethra, could detect the end about four 
or five inches down from the glands penis, and by grasping 
the urethra and holding it and the catheter and pushing 
down on the glands we succeeded in moving it forward by 
jets, as it were, until we could reach it with a pair of nasal 
forceps. I must say I was rejoiced over our triumph, and 
many congratulatory remarks were made by the friends 
over our success. 

Never before has such an accident occurred in my 
practice ; nor haVe I ever read of it occurring to others, and 
I WTite this to caution others in the use of this invaluable 
instrument. 

MoEAL. — When leaving a Jaques catheter wdth unedu- 
cated nurses, always attach a small cord or string to the 
end, then the instrument can't escape. 



Art. IV. — " Preserves " : A Recipe — With a Preface. By Chas. H. C.uiter^ 
M. D., Chicago, Illinois. 

Periodicals devoted to the diffusion of the facts and 
theories of medical sciences, and we might add, to the man- 
ufadure of '"facts" and "theories", are legion, and their 
numbers constantly increasing. The eagerness of the mem- 



^98 The Peoria Medical Monthly. 

bers of the profession, both young and old, to rush into 
print, is becoming as great a rage as the craving for the 
:afl&x " Prof." attached to the name. To give the aspirants 
a chance to reach the goal of their ambition, medical jour- 
nals and medical colleges must multiply pari passu. 

I have no fault to find vi^ith any honorable means of 
*' rising ", nor with any healthy competition in the race for 
fame or fortune. Give every one a fair chance and the fit- 
test will survive. Those who fail to excel, will at least 
force others to greater efforts, and among so many com- 
petitors can hardly fail to see some left behind them in the 
struggle. The desire to "make a mark" is commendable, 
and the thirst for approbation seems to be one of the inborn 
qualities of the average man. But beyond all this selfish- 
ness, there is, in the medical profession, an earnest seek- 
ing after exact knowledge ; and many are taking advice 
from Bacon and endeavoring to gain exactness by writing 
the products of their brainwork in the form of theories, and 
by recording the facts which their experience seems to 
them to establish. Through the medium of the medical 
press their illuminations of medical obscurities are removed 
from under the mental bushel (more or less) of the author 
and set on candlesticks to shine as beacon lights for the 
guidance of their fellow mariners. 

Thus, with the multitude of thinkers and writers, the 
journals are well supplied with "copy", and such journals 
labor hard to secure a share of patronage, and consequently 
" natural selection " again comes into play, and the very 
.struggle to deserve support, is as conducive to the attain- 
ment of that end, with the medical journal as with the 
medical man, each striving to " fill the bill " better than its 
{too near, perhaps) neighbor. 

We are deluged with journals of every name, and de- 
Toted to every department and swi-department of medical 
study. A great majority of them, if properly used, have 
.suflicient excellence to be worth their cost. Some of the 
•cheapest and most unpretending are really the most useful 
to the practical physician. Most of the larger and most ex- 
pensive journals aim so high that the practical is almost 
completely sacrificed to the theoretical, or too much prom- 



Original Communications. 399 

inence is given to reporting rare cases and to tedious discus- 
sions of matter, which the majority in the profession can- 
not apply to the solution of the problems which are daily 
presented to them. 

The choice of a certain number of the journals w^hich 
the physician can afford, and can use to advantage prac- 
tically, is usually a perplexing question, and the fewer one 
can afford the more difficult it is to decide which to choose 
and which to reject. 

The progressive physician desires to have as many 
"tools" and materials as he needs in the form of books and 
periodicals, and this w^ith as little lumber and waste as pos- 
sible. The number of journals he should take or the amount 
of such literary matter he can make use of depends on hoiv 
he uses it. And further, the profit he will derive from the 
investment depends on how he preserves it, so it may be 
utilized at any subsequent time. If he is contented with a 
single and perhaps hasty perusal, and especially if he has 
no immediate opportunity for the practical application of 
what he reads, and the journal is consigned to the shelf 
sine die, he will derive comparatively little benefit from it, 
unless, perchance, he has been gifted with a prodigious 
memory. The journal is thus made to perform only one of 
its functions — that of being a medical we^rs-paper, and will 
"waste its sweetness", and fail in its most important office 
as a reference-work with an inexhaustible store of helpful 
hints and teachings. 

As great a variety of periodicals should be selected as 
can be carefully read without interfering with other duties, 
and a means of referring to those portions of their contents 
worthy of preservation, should be preferred. 

Every professional man must be constantly studying, 
to polish up the rusty places in the memory, and to keep 
abreast of the world of progress about him. The volumes 
of journals should occupy a place next to the standard 
works in the medical man's library. They contain valua- 
ble matter not found in any text-book. 

It is true, each volume of journals has an index ap- 
pended to it, but as the volumes accumulate the task of 
finding what is wanted becomes very great, for even the 



400 The Peoria Medical Monthly. 

titles of many valuable articles will be forgotten, and thus 
be lost sight of, buried in an impenetrable mass of mingled 
valuables and rubbish, with no clue to lead to their hiding- 
places. 

The busy practitioner cannot afford to waste time in 
searching for information. Neither can he ignore the 
teachings and experience of his predecessors or contempo- 
raries. The more he avails himself of these auxiliaries the 
better for the people who trust their physiological discords 
to him for tuning. 

Now for the recipe for " preserving " the more choice 
contents of the journals, etc., so they may be easily and 
quickly found when wanted. How can they be " pickled " 
and labled so as to be always ready for use ? 

Note-books will not answer the purpose, for they them- 
selves require an index to be of any practical value, and 
even their sphere of usefulness is very limited, for volum- 
inous note-books are as difficult to handle as the sources of 
the notes. 

Blank index-books are somewhat better, but they can- 
not be used long, as the entries will soon be so many as to 
make it impossible to preserve the proper alphabetical ar- 
rangement. 

The only index which fulfils every requirement is the 
card-index. By this means an index of the whole range of 
literary matter of the most industrious reader may be class- 
ified under proper headings and rendered readily accessi- 
ble. 

Cards about the size of a postal-card are arranged in a 
tray or box, or, as I have mine, in a shallow drawer in the 
writing desk. Each letter-division is separated from the 
contiguous one by a slip of paper pasted on the first card 
in each division. This slip extends about half an inch 
above the cards and is labeled with the letter correspond- 
ing to the cards immediately below it. 

This set of cards forms an index which is always per- 
fect in arrangement ; each new card being inserted in its 
exact place, and this place remains its place, no matter 
how many cards may be subsequently added, since the sub- 
jects in each letter are also arranged alphabetically like 



Original Communications. 401 

the words in a dictionary. For example : the "abscess" 
card comes before the "ankle" card, and an "ache" card 
may be at any time inserted between them, aad " ague ", 
*' asthma ", and " ascarides " need not cause any disturb- 
ance. There is a place for everything and room to spare. 

By its cheapness, simplicity and expansibility, it forms 
the only mdex rerum which is absolute perfection. Sep- 
arate note-books for different subjects are not needed, as 
the index, if properly prepared, will have all the necessary 
headings, under which any point may be looked for. It is 
gradually unfolded by daily accretions, and by a few mo- 
ments of work each day it may soon become a complete 
index to a man's library. 

Nothing is easier to have a small note-book and a pen- 

^ cil at hand when reading, and the titles or " catchwords " 

of any article or item one desires to index, noted at the 

time, and in a leisure moment transferring the notes to 

their proper places in the index. 

I have used such an index three years, and it now con- 
tains about three thousand cards, and I am sure it has 
already served me ten times the time I have employed in 
making it. 

1 not only index the important articles and items in 
my medical journals, but also those in my scientific and 
literary periodicals, and scrap-books made from newspaper- 
cuttings. Interesting points in my medical and miscella- 
neous books are also more quickly found when wanted, if 
they are put in the index. Among several hundred books 
it is no easy matter to " look up " a partially or entirely 
forgotten "squib". 

I commenced my index with the intention of using it 
simply as a means of getting the full value out of my med- 
ical journals, but finding it working so admirably for that 
purpose, I gradually broadened its scope till it is now used 
as a veritable "catch-all", without at all disturbing the 
carrying out of the original purpose. I almost wonder how 
I ever " kept house " without it. My wife finds it " a very 
pleasant help in time of trouble " when she forgets in what 
number of her Household Journal she will find the recipe 
for making "mock oysters" or "snow-ball custard", or 



402 The Peoria Medical Monthly. 

where she saw Carlyle's opinion about ladies studying and 
practicing medicine, etc., etc. One index will serve for 
'■ a whole family ", and all will declare that it is a good 
thing to have in the house. 

A professional man's study lacks one of its most valu- 
able pieces of furniture if the card-index is left out. 

I would advise every reader of the Peoria Medical 
Monthly who is not using it, to begin it with the new year. 
It will pay. Select your medical and other periodicals, as 
many as you can afford and use, and keep right up to date 
with the indexing. It will soon become a habit to make 
notes and index them, and the idea of its laboriousness will 
not be thought of. Then, when a subject is to be studied, 
all the matter pertaining to that subject in the library is 
found without wasting a moment of time in '* searching for 
a needle in a hay-stack." 



Art. V. — A Case of Pistol Shot Wound Tlirough the Liver and Lung — Re- 
covery. By a. R. Small, M. D., Decatur, 111. 

About 11 o'clock, on the nignt of Nov. 27, 1881, while 
in a bagnio. Jack Lahey received a shot from a 32- 
calibre pistol, the ball entering just below the sternum, 
and just to the right of the median line, taking an oblique 
course to the right and slightly upward, and lodging just 
anterior to the inferior angle of the right scapula. 

Dr. C. Chenoweth was immediately called and found 
him in a partially collapsed condition, suffering great pain 
and spitting blood freely, though very little escaped 
through the external wound. 

The wound was covered with an adhesive plaster and 
a bandage applied tightly around the lower part of the 
chest to restrain motion, and morphia administered in suf- 
ficient quantity to relieve pain. 

At the request of Dr. Chenoweth I visited the patient 
on the morning of the 28th, and with him attended the 
case throughout. 

We found the patient resting quite comfortablj^ 
breathing comparatively easily and occasionally spitting 
blood. 



Original Communications. 405 

In about five days he commenced spitting up pus with 
the blood, and in from eight to ten days pure pus. Up to 
the eighth day there were no unfavorable symptoms, the 
pulse not being over 90 and the temperature but little- 
above normal. 

We gave him just morphia enough to relieve pain, and 
ammon. iodid. 1 grain every two hours in solution, and 
quinia sulph. and acid salicylic aa. 2 grains in capsules 
every four hours, and whisky as needed. On the eighth day 
there was profuse perspiration, sufficient to weaken the 
patient considerably and a tendency to collapse. We gave 
gallic acid 5 grains and ext. belladon. ^ grain in capsules- 
every two hours, which controlled the sweating, and from 
that time he gained steadily until well, being able to sit up 
all day within three weeks from the time he was shot. We 
did not find the ball until several days after the injury, 
when by raising the right arm, so as to lift up the scapu- 
la, the ball could be felt just beneath the skin. The in- 
ferior part of the scapula covering it when the arm was in 
its normal position. From the direction of the ball it must 
have penetrated the upper portion of the liver, the dia- 
phragm, and the inferior lobe of the right lung. The 
wound was drained entirely through the lung by expector- 
ation, as the external wound was entirely healed within a 
w^eek and not a particle of discharge took place from it af- 
ter the first six hours'. 

The case is of interest in showing the severe injury 
that may be suffered by important organs with conpara- 
tively slight constitutional disturbance. 



Basham's Mixture in Albuminuria. 

This old-fashioned formula still holds a prominent^ 
place in the treatment of renal disorders. Its compositiorL 
is as follows : Tr. ferri chlor. i ounce ; acid acetic dil. 1 
ounce; liq. amm. acet. 4| ounces; tr. aurant. cort. 1^ 
ounces ; glycerine, | ounce. M. Sig. A tablespoonful^ 
largely diluted, three times a day. — Canada Lancet. 



404 The Peoria Medical Monthly. 

A Thought With Reference to Feiimr Fractures. 

Frankton, Ind., Feb. 1, 1S83. 
Editor of Peoria Medical Monthly : 

I have a few items to present to my medical brethren 
through your interesting columns which are gathered by 
actual experience, and are more especially submitted to 
their consideration as inquiries rather than otherwise. On 
the 23d of last October I received an oblique fracture of my 
right femur near the center. The point of interest is this : 
by careful watching of my own case I am constrained to 
believe (however without any good written authority so far 
as I know) that that there are certain periods or points 
reached, beginning ten days after union, and lasting 
up until the provisional callous is eompletely removed, con- 
sisting in what we would term a crisis, marked by a dis- 
discharge from the kidneys of an abundant amount of al- 
buminous substance loaded with lime in a mechanical 
rather than a chemical condition, recurring about every 
seventh or eighth day, lasting about thirty-six hours, then 
entirely subsiding for the time. Some burning pain while 
and after urinating, bat urine passed freely and in sufficient 
quantity. Some depression of a nervous character would 
precede for about twelve hours this return of abnormal 
urine. Before fracture was healthy, of a nervous temper- 
ament. 

No kidney trouble of any kind had ever been detected, 
but at the time of injury some trouble to urinate owing 
to rigidity of the sphincter muscles of bladder, but passed 
off without treatment ; was a quick urine, no constitu- 
tional trouble, no remedies internal ; was treated with a 
straight splint with the crotch extension. And now at this 
writing, ninety-five days from fracture, I have been walk- 
ing at a tolerably fair gait without crutches or cane. The 
points of interest to me are these : was a very large pro- 
visional callous up until about the thirtieth day, Began 
to subside rapidly and now for the last thirty-five days 
there is not a particle of callous to be found by the closest 
inspection. Since the callous has entirely disappeared. 



Correspondence. 405 

urine normal in kind and quantity. Health good. Now 
I wish to ask my medical brethren, was that abnormal 
condition of urine a healthy excretory process of the sys- 
tem through the kidneys to get rid of that provisional cal- 
lous, or was it not ? The office of the kidneys being to 
eliminate the earthy and bone materials which have be- 
come effete and surplus in the system. If this periodicity 
of abnormal condition of urine is consequent and necessary 
to the removal of provisional callous in each and every case 
of fracture (as I believe it was in my case without a doubt), 
it would appear to me that such grave symptoms (being 
only a sequel), deeply implicating the kidneys, should be 
by our surgical authorities treated of and regarded as such. 
Dr. F. Hamilton gives us where the callous is obtained and 
how, but no farther. 

I ask the question, was this condition normal or ab- 
normal, showing itself only the twenty-eighth or thirtieth 
day alter the fracture, returning every seventh day, lasting 
about thirty-six hours up to the sixtieth day, then passing 
off entirely ? J. D. Ebert, M. D. 



A Brief Treatise on Therapeutics. 

HOW TO CONSTRUCT A PRESCRIPTION. 

The sti.dent when brought in contact with disease, 
single handed and alone, is often sorely puzzled to tell 
what to prescribe, and how to go about it. He may have 
heard lectures on the practice of physic, and been told that 
constipation may be treated by vegetable and mineral 
purgatives ; but how to combine them, and in what doses 
to give them he is unable to decide. Or he may have heard 
Materia Medica lectures, and been told that iron is indica- 
ted in aneemia ; but he is far from seeing his way to pre- 
scribe it satisfactorily. Suppose the case is that of a pallid 
man, with constipated bowels : the first thing to be done is 
to select a suitable laxative, say sulphate of magnesia. 
Now comes the dose. As it is to be taken several times a 
day, the dose must be much less than when given in one 
dose, as a purgative. For the latter, the average dose is 1 
oz., but as a laxative it will be found that 1 dr. is usually 
•quite sufficient three times a day. Then there is the 



406 The Peoria Medical Monthly. 

anaemia to be considered. For this the old tincture of 
the muriate of iron is well adapted, in a dose of ten drops 
at a time. We have now got the main elements of the pre- 
scription together, viz : magnesium sulphate, 1 dr. and 
tine. fer. mur. 10 min. But in all probability this mix- 
ture will gripe the patient more or less unless it be given 
with some warm agent or carminative. Consequently, 
then, the vehicle in which the essential factors are to be 
taken is not an unimportant matter. If the appetite be 
good, then mint water may be selected. The complete pre- 
scription would then stand : 



Masjnesium sulphate, 


1 drachm. 


Tincture of iron, 


10 minims. 


Mint water. 


1 ounce. 


Three times a day. 





But if, as is very likely, the appetite is defective, it is 
well to select a vegetable bitter as the vehicle. As many 
of these vegetable bitters contain tannin, they do not go 
well with iron, giving an inky color to the mixture, and so 
rendering it repulsive to the eye. And medicine is not 
usually very attractive at the best ; so it may not be made 
more objectionable than is absolutely unavoidable. So the 
bitter selected may be infusion of quassia. But quassia is 
not carminative, so it is well to add either tincture of gin- 
ger or of capsicum. The prescription would then stand : 

Magnesium sulphate, 1 drachm. 

Tincture of iron, 10 minims. 
Tincture of ginger, 1 drachm. 

Or Tincture of capsicum, 10 minims. 

Infusion of quassia, 1 ounce. 
Three times a day. 

Or the patient has a cold, with some bronchial imflam- 
mation present. Then the line would go in this direction: 
First we require an agent which will make the action of 
coughing more efficient, while it also acts upon the bron- 
chial lining membrane, making the secretion more free, 
and thus causing the phlegm to be more readily dislodged. 
Such an agent we find in ipecacuan. Say, then, ipecacuan. 
wine, 15 minims. Then, in all febrile conditions, it is well 
to excite the action of the skin. For this end the acetate 
of ammonia is indicated. As I do not intend to confine 
myself to prescriptions in English, but shall use Latin ones 
at times, for the better education of the reader, so as tO' 
familiarize him with both, this will stand : 

Vini ipecacuan, 15 minims. 

Liq. amm. acetat, 1 ounce. 

6ta quaque hora. 

Or the patient is recovering from some acute disease,, 
as typhoid fever, or pneumonia, and the tongue is not quite. 



Periscope. • 407 

clean, and the appetite not active. Here a mineral acid is 
indicated, as phosphoric, for instance ; in a vegetable infu- 
sion which need not be free from tannin, as iron is not to 
be in this mixture. Consequently the prescription will 
stand thus : 

Dilute phosphoric acid, 15 minims. 

Infusion of cinchona, 1 ounce. 

Thrice daily 

Under this combination probably the tongue will clean, 
and the appetite improve. 

Then it is well for the student not to forget that acids 
and alkalies do not go together, but combine, a fact not al- 
ways remembered by young practitioners. Thus, for in- 
stance, in dyspepsia with much acidity, it would not do to 
w^rite the following prescription : 

Soda bicarb, % scruple. 

Liq. strychnicB, 4 minims. 

Inf. gentian 1 ounce. 

The strychnine being dissolved in an acid medium, 
hydrochloric acid would be thrown down in an alkaline 
mixture, with this result, the strychnine would be at the 
bottom of the mixture, and consequently the patient would 
get none of it till he came to the last dose, aud then he 
might get more at once than was quite agreeable. In such 
cases the Galenical preparation must be chosen, the tinc- 
ture of nux vomica. The prescription then ought to 
stand : 

Sodfe bicarb, }4 scruple. 

• Tinct. nucis vom, 10 minims. 

Inf. gentian, 1 ounce. 
Ter in die. 

To give iron with a vegetable bitter containing tannin 
is a very common error, producing a repulsive looking 
fluid. But this avoidance of iucompatibles went to an un- 
desirable length, when it decided that digitalis could not 
be combined with tincture of iron. In cases of heart weak- 
ness the following is an excellent combination : 

Tinct. digitalis, 10 minims. 

Tinct. ferri. mur., 10 minims. 

Sp. chloroform, 20 minims. 

Inf. quasbiiS, 1 ounce. 
Ter in die. 

vSpirit of chloroform is pleasant to the taste, and can often 
be added to mixtures with advantage ; it is also a stim- 
ulant. 

Or a patient may have constipation, with a foul tongue 
and a bad taste in the mouth. Here the fur, which con- 
sists of dead epithelium cells which are not properly shed, 
is usually stained by the bitter bile acids or their salts, so 



408 The Peoria Medical Monthly. 

it is well to give a laxative which will also contain an in- 
gredient which will act upon the liver, as mercury, for in- 
stance. The combination would then stand thus : 

Pil. laydrarg., 1 grain. 

Pil. col. CO., 8 grains. 

To be taken at bed time. 

If the bowels are not freely opened, then a seidlitz 
powder, or an ounce of "black draught" in some warm wa- 
ter next morning. Morning laxatives should always be 
taken warm. By so doing their action is more rapid, and 
the bowels are less apt to tease the patient during the 
course of the day, which is often very inconvenient. These 
minor matters are usually worth attention. 

INDICATIONS FOR TREATMENT. 

After making a diagnosis as to what is the matter with 
a patient, the next thing to be done is what is the leading 
indication for treatment. The patient may be suffering 
acute pain, as in colic. Here'the pain is at times excru- 
ciating and must be relieved. For this end opium stands 
facile princeps. "Mash Allah" (the Gift of God) is stamped 
on the cakes of opium by the Orientals. Then as the colic 
is due to violent spasm of the muscular fiber of the intes- 
tine, it is well to give the opium with a carminative, as 
mint water, for instance, which will make a convenient 
vehicle. Then the pain is very depressing, as all pain is in 
which the abdominal portion of the sympathetic nerve is 
involved, and therefore a diffusible stimulant, acting rap- 
idly, is desirable. Such an agent we possess in carbonate 
of ammonia, of which sal volatile is a preparation. It 
Avould be well, then, to let the prescription stand : 

Tinct. opii, % drachm. 

Sal volatile, 1 drachm. 

Aq. menth. pip., 1 ounce. 
Statim. 

In cases of severe depressing pain, a full dose of opium 
at once is in every way better than repeated small doses. 
(A word of caution as to dose. Children are very suscepti- 
ble to opium, and small doses often act very potently upon 
them. M\ agents which "depress" nerve action as part of 
their effect, are to be given with caution to children.) In 
many cases of colic the only thing at hand may be some 
laudanum and some spirits. It would then be well to give 
the laudanum with two ounces of any spirit. In any case 
of colic, it is well to put cloths wrung out of hot water, 
and freely sprinkled with turpentine, upon the abdomen 
until relief is attained. 



Periscope. 409 

Or the patient may be in a fit. Here, really, little can 
be done except to see that the patient does not do himself 
or herself any injury, if convulsed. In epilepsy, to loosen 
the collar and free the neck is indicated ; and if the tongue 
is being bitten, put a piece of soft wood or cork betwixt the 
teeth to prevent the tongue being nipped. If a young wo- 
man, and especially screaming, it is probably hysteria, and 
then a jugful of cold water dashed over the head and face 
is effective, or a hand may be placed over the nose and 
mouth till the performance is arrested and converted into 
a struggle to breathe. If it is pure syncope, it is well to 
allow the patient to remain in the recumbent posture un- 
til spontaneous efforts are made by the patient. In syn- 
cope there is temporary failure of the heart's action, and it 
is not desirable to remove the patient from the horizontal 
posture, until there is evidence of the circulation being re- 
stored. If the patient be not in the horizontal posture 
when the faint comes on, she should at once be laid flat. 

Or the patient may be bleeding profusely. Here it is 
desirable to put pressure on the vessels from which the 
blood flows. If from an artery, the pressure must be be- 
tween the heart and the bleeding orifice ; if a vein, at the 
distal end of the limb ; if hsemoptysis, or haematemesis, 
keep the patient absolutely still under all circumstances. 

And now let me tell the youthful reader what he must 
NOT do. He must not give a stimulant if the patient faint. 
Here syncope is nature's mode of arresting the hemorrhage; 
and though it may appear to indicate a supine and indiffer- 
ent attitude, it is not wise to interfere with the syncope. 
To give a stimulant is to excite the heart's action, to rouse 
the circulation, and restore the hemorrhage. But so carry 
yourself that the alarmed bystanders shall recognize the 
fact that your inactivity is not the consequence of ignorance 
and indifference, but of greater know^ledge than they pos- 
sess. In their good intentions, persons guided by impulse, 
combined with ignorance, may become murderers. 

Or a patient may be suffering from great excitement, 
from brain disturbance, or from being mentally upset. 
Here a calm, self-possessed manner and bearing are of the 
greatest service, but medicine may be useful. Here a seda- 
tive is indicated, as chloral hydrate, or bromide of potas- 
sium — alone or combined, and they may be given in w4iat 
is termed a calmative, as camphor mixture, for instance. 
The i^rescription would stand : 

Chloral hydrate, • % scruple. 

Potass, bromid., 1-2 drachm. 

Mist. camphorEe, 1 ounce. 



410 The Peoria Medical Monthly. 

If required, this must be repeated in three or four hours. 
All depressant drugs are to be given with care and pru- 
dence, and the action of opium, chloral, and bromide of po- 
tassium will be contrasted in a subsequent chapter. 

Or the patient may be suffering from dyspnoea — the 
respiratory efforts being very laborious. Here it is well to 
give rapidly diffusible stimulants, wiiich act promptly on 
the centres of the circulation and the respiration. Such 
agents we possess in ammonia, belladonna, and strychnia, 
while digitalis acts powerfully upon the heart. It will be 
well to prescribe in severe dyspnoea either : 

Amm. carb., 5 grains. 

Sp. chloroform, 20 minims. 
Liq. atropifB sulph., 2 minims. 

Aq., 1 ounce. 

to be repeated in two or three hours ; or if the right ven- 
trical be falling, the prescription would be : 

Am. carb., 5 grains. 

Tinct. nuc. vom., . 10 minims. 

Tinct. digitalis, 10 minims. 

Aq. menth. pip., 1 ounce. 

also to be repeated if necessary. Or if the reader be very 
inexperienced, not familiar with modern therapautical re- 
search, he might take a lower but safer {i. e. as regards 
public opinion, but not as regards the patient's life) stand- 
ing ground, and prescribe : 

Sal volatile, 1 drachm. 

Sp. chloroform, i-^ drachm. 

Aq., 1 ounce. 
4ta quaque hora. 

Where there is acute indigestion, it is well to empty the 
stomach by administering an emetic, as suphate of zinc (3 
scruples), or ipecacuan wine (an ounce) ; or if these be not 
at hand, some mustard and hot water, or tickle the fauces 
with the finger until vomiting is induced. The same holds 
good of acute alcoholism. In all emergencies keep as cool 
as possible, and do not act hurriedly or excitedly, or you. 
may do the wrong thing and defeat your aim. 

Then there is the question of the local measures to be 
employed. Heat is almost always soothing, except in head- 
ache, where cold applications give more relief. Cold water 
and vinegar, and eau de cologne, where practicable, are 
good measures for headaches. In dyspnoea, where the right 
side of the heart is embarrassed, it is well to put hot 
poultices to the front of the chest ; the heat stimulates the 
heart. In local abcesses a hot poultice is soothing. The 
case may be one of a broken rib, where a jagged end is rub- 
bing the lung-pleura at every respiratory act ; here the 
most efficient local measure is to put the parts to rest, or 



Periscope. 411 

as uear as is attainable, by strapping, or banding. In that 
form of pleurisy where a small module of tubercle, pro- 
truding from the lung, rubs on the costal pleura, and ex- 
cites local inflammation and pain, then putting the part at 
rest by strapping gives the patient relief. Or there is a se- 
vere bruise causing much pain. Here soothing applications, 
as a piece of folded flannel, wrung out of hot water, and 
freely sprinkled with laudanum, or a poultice of poppy 
heads, are good measures to adopt. If a sprained joint is 
very painful, it may be swathed in bandages soaked w^ith 
€old water, or cold water allowed to drop on the bandages. 

WHAT TO AIM AT. 

When called in to see a patient, the student must ex- 
pect to find the person acutely ill, or thought to be so by 
those around — relations, friends, or neighbors. The first 
thing to determine is, which is the case. It is not ahvays 
easy to do this. How to determine which of the two is the 
case calls out the extent of the practitioner's knowledge, 
and tests the attention he — w^hether a young or an ad- 
vanced student — has paid to the instructions of his clin- 
ical teacher. If the pulse, respiration and temperature all 
be over the normal, then organic mischief of an acute char- 
acter is usually afoot. On the other hand, there may be 
collapse or rupture of an internal blood-vessel without any 
of these. When so called in, do not rush at the patient 
with a stethoscope, but find out something about the indi- 
vidual, and then proceed to the disease and its amount. It 
is quite as important to know something of the patient gen- 
erally, as it is to determine the extent of a pneumonia, for 
instance. You are going to treat the patient rather than 
the disease. You are going to influence the morbid process 
in the individual. Above all things, keep your head clear 
and cool, and so give your knowledge, be the same more or 
less, a fair chance to exhibit itself. First give relief to the 
patient ; then relieve the minds of the friends. Make as 
good an impression as you possibly can, in order to acquire 
the confidence of the patient and the patient's friends, so 
that they will follow your instructions implicitly. The 
success of your plan of treatment will usually turn on the 
thoroughness with which it is carried on, and if you do not 
secure the confidence of the patient's friends, you may be 
pretty certain that they will not follow your instructions. 
Never be oblivious of the fact, nor be too acutely conscious 
of it, that the friends are examining you while you are ex- 
amining the patient. Bear yourself accordingly, and it is 
better to err, if err you must, on the side of excessive care 



412 The Peoria Medical Monthly. 

in your examination. Youth is apt to be self-confident, and 
it is very easy to make a mistake, even when years have 
rolled over the practitioner's head and taught him caution 
by a painful experience. Be not flippant then, and carried 
away with the impression that you have arrived at your 
diagnosis by some inspiration. Be painstaking in your ex- 
amination, and thoughtful in your plan of treatpient. — J. 
Mibier Fofhergill, M. D. M. B. C. P., in LeonanVs Illustrated 
Medical Journal. 

(to be continued). 



Puerperal Diabetes. 



A paper on this subject was read by Dr. Matthews 
Duncan, at a late meeting of the London Obstetric Society. 
The author pointed out the distinction between the slight 
glycosuria of pregnant and suckling women and real dia- 
betes, with its real polyuria and large amount of sugar. 
Physicians and surgeons w^ere well aware of the dangers 
introduced into their cases by complication with diabetes. 
But the subject of diabetes complicating pregnancy and par- 
turition had attracted almost no attention ; and this prob- 
ably arose from its rarity, which might be accounted for by 
the disease frequently destroying in women the sexual en- 
ergies, as it is said to do in man. The author had collected 
twenty-two cases in fifteen w^omen, and they demonstrated 
the great gravity of the complication as respects both 
mother and child. Of the twenty-two pregnancies (includ- 
ing those ending prematurely) four had a fatal result soon 
after delivery. In seven of nineteen pregnancies in four- 
teen women, the child, after reaching a viable age, died 
during pregnancy; in two the child was born feeble and died 
in a few hoars — making an unsuccessful issue in nine of 
nineteen pregnancies.- The histories showed that diabetes 
may supervene on pregnancy: that it may occur only during 
pregnancy, being absent at other times; that it may cease 
with the cessation of pregnane}^ ; that it may come on after 
its cure. They showed that pregnancy may occur in a dia- 
betic woman : that it may be not appreciably affected in its 
natural progress and termination by the disease, and that 
it is very liable to be interrupted by the death of the foetus. 

Dr. Robert Barnes had investigated the condition of 
the urine in pregnancy, as to albumen, urea, and sugar. The 
occurrence of sugar was physiological, though not constant. 
Sinety had shown that sugar appeared in the urine when 
lactation was suppressed : this w^as of interest in connec- 
tion w^ith the normal fatty change in the liver shown by 



Book Notices. 413 

Tarnier to occur in pregnacy. He (Dr. Barnes) drew a par- 
allel between albuminurea and glycosura during pregnacy. 
Both were physiological, but might pass the physiological 
boundry, and then grave accidents ensued. — L'sv. Med. Neivs. 



Transactions of the Thirty-Second Annual 3Ieeting of the Illinois State 
Medical Society. Held ut Quincy May 16, 17, 18, 1882. 8vo.; cloth; 274 
pages. Printed by Chas. J. Johnson, Chicago, 111. 

After months of waiting and questioning on the part 
of members of the Society the annual volume of transac- 
tions has put in an appearance. To compare it with 
previous volumes from this Society or with the transactions 
of the societies of other states might seem invidious. 
Comparisons are generally odious, hence had better not be 
made lest our State Society might feel discouraged. To 
briefly notice a few of the most worthy papers presented 
must suffice. After the address of the President, w^iich is 
a model of its kind and should be read by every physician 
in the state, comes the Report on Practical Medicine by 
Dr. Ensign, Chairman. This report may well be considered 
as typical of what such a report should be, although the 
reluctance of physicians to answer Dr. Ensign's circulars 
somewhat marred its completeness. It is well worthy of 
re-reading and preservation. 

Obstructions in the Larynx and Trachea, by E. Fletcher 
Ingals, comes next, which we only note, to wonder why his 
titles as professor, etc., are made a foot-note and why they 
should appear at all. 

Dr. Lee of Chicago made the report on Surgery, review- 
ing at some length the subject of Antiseptics, Skin, Sponge 
and Bone-grafting. 

The report on Gynecology by Dr. E. W. Jenks was one 
of the features of the meeting, and is one of the valuable 
features of this volume. 

The reports on Medical Legislation take up about fifty 
pages of the book and excite the question cui bono. What 
good did they do 1 The reports are good enough in them- 
selves, but are they not like fighting the wind ? 

Beyond the above mentioned there are some that rise 
above mediocrity and some which do not even attain it. 
The mistakes of the proof-reader are many and inexcus- 
able. Proper names are mis-spelled, or assigned to the 
wrong locality, with a frequency that should demand a re- 
form, and we hope that the volume for 18S3 will be an im- 
provement in this respect at least. 



TIEIiE] 



Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jefferson Street, .... PEORIA, ILL 

*♦* All exchanges, books lor review, aud communications must be addressed lo th 
Ejitorand Publlslier. 

***Tlie publication day of tliis journal is on or about tlio loth of eacli uioutli 
***To subscribers! A pencil mark at this place Indicates that the time of your sub- 
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^tUtoviJil S^Jiiailnunt. 



The Fourth Animal Report of the Illinois State Board of 

Health. 

Five years and a half have now elapsed since the State 
Board of Health of Illinois was estalilished, and its fourth 
report lies before us. A slight review of the w^ork 
accomplished may not at this time he thought out of place. 

The first two years of its labor may be said to have 
been spent in getting ready for work. The general state 
of affairs in all matters pertaining to the practice of medi- 
cine ill this State was as bad as it now is in those States 
having no laws upon the subject. Quackery was rampant 
and unconcealed, itinerants were found in almost every 
country town; the only requirements for the practice of 
medicine were a " shingle '' and plenty of brass. 

With a law confessedly imperfect, with the scarcely 
half-hearted support of a majority of even the reputal)le 
practitioners, in the face of the most bitter and undisguised 
opposition of the irregulars and quacks, and without the 
moral support or sympathy of the people at large, the 
newly appointed Board began the work of restoring order 
out of chaos. There were few precedents to follow, laws 
regulating the practice of medicine w^ere a novelty, and 
wdiat was done had to be done slowly, feeling the way for 
firmer ground beyond. A few false steps, a few blunders, 
and all would have been lost. What wonder, therefore, 
that the first j^ear and a half or two years bore so little 
apparent fruit; what wonder, too, that many persons both 



Editorial Department. 415 

in and out of the medical profession, criticised the Board 
severely and blamed it for neglect of duty, or even worse. 

The causes for this slow progress were not so apparent 
then as they have since become, and the motives of the 
grumblers were perhaps not evil. 

After the Board had carefully examined the ground, 
progress became more noticeable, the law was tested in a 
few cases and generall,y sustained; frightened at the in- 
creasing vigor of the Board, the most flagrant quacks left 
the State, and itinerants began to give Illinois a wide berth, 
until to-day this State is as free of those vampires as any 
other one in the Union. 

Space wdll not permit of a review of the labors of the 
Board during the recent epidemic of smallpox, but its 
vigorous action and the untiring efforts of the Secretary 
gained for it general praise, and for him the credit of being 
one of the most energetic and advanced sanitarians of the 
country. 

The actions of the Board in regard to medical educa- 
tion have also been in the main, well taken and good. The 
refusal to receive diplomas from several colleges has caused 
some of them to raise their requirements, and its new rule 
to receive no diplomas from any medical college not having 
an entrance examination in the common English branches, 
has caused all that were previously remiss to fall into line. 

Another step should be made, and that is the revision 
of the act regulating the practice of medicine, and the 
act establishing the Board of Health, both of which are 
notoriously faulty. 

The good that the Board has accomplished, even under 
these disadvantages, has gained tor it the confidence of the 
people of the State, and the good v/ill of the medical pro- 
fession.- The old prejudice has almost died out, the old 
opposition has been overcome, and we believe the time has 
now arrived when the laws may be amended and 
strengthened. To move in this, should be the work of the 
Board, and we hope it will be undertaken before the 
adjournment of the present legislature. 

Much good has been accomplished in the way of edu- 
cating the people to the necessity of sanitation and 



416 The Peoria Medical Monthly. 

prevention of disease b}' the circulars of the Board which 
have been widely distributed, and we hope the work will 
be continued. 

The Board should receive the hearty support of the 
profession, not the support manifested by simple non-oppo- 
siti-on, but working support and active co-operation; were 
this had its progress would be more rapid and results more 
satisfactory. 

In conclusion we wish to saj^ a word in reference to 
the Secretary of the Board, Dr. Eauch, whilst personally 
he may not be popular with all, still there is not a candid 
man who can have any other feeling than that Dr. Ranch 
has succeeded where ninety-nine out of a hundred would 
have failed; that he has done more hard work than almost 
any other n-an who could have been found for the place. 



Tlie Xew York Code. 

The seventy-seventh annual meeting of the New York 
State Medical Society was held in Alliany, February 6, 7, S. 
The number in attendance is not given in any rej^ort that 
we have seen, but judging from the vote on the code, there 
were about 205 present. 

To one at this distance it looks as if the gag-law was 
strictly enforced on all opponents to the new code. As for 
instance, when the Westchester County Society presented 
a communication representing their loyalty to the Ameri- 
can Medical Association and deprecating the action of the 
State Society, it was moved that the Society be repri- 
manded, and it was later moved that all similar communi- 
cations be placed on file without reading. 

This is sufficient to show the animus of the defenders 
of the new code, almost all of them by-the-by New York 
City men. It made no difference that thirty-eight out of 
forty-three county societies repudiated the new code. New 
York City had enough present as delegates and permanent 
members to carry everything. 

The final vote on Dr. Squibb's motion to abrogate the 
action of the Society last year, and to re-establish the code 



Editorial Department. 417 

of the American Medical Association, was lost by a vote of 
105 to 99. 

Tliis settles the matter for the time being, and that 
this action may prove wise hopes the New York Medical 
Journal. It may turn out, however, that the majority of 
the members of the profession in the state outside of New 
York City, will dissolve their connection with the State 
Society and form a new state organization that will be in 
full accord with the National Society. In this they will be 
joined by many prominent men in New York City. 

Dr. D. B. St, John Roosa appeared as champion of the 
new code. He repudiated the statement that the State 
Society were secessionists. They had no relation with the 
American Medical Association. They sent delegates to it, 
but were not in any way connected with it. They did not 
I)ropose to permit this Society to be dictated to by any 
voluntary society, etc. 

It may be time that the old code of ethics be revised, 
and in fact it ought to be done, but it seems to us that the 
New York Society have adopted a very poor method to 
secure this end. 



Important Announcement. 

On April 1st we propose to issue the first number of a 
popular Journal of Hygiene, which w^ill be devoted to the 
advancement of practical knowledge of the laws of life, 
sanitation in its widest extent and all subjects pertaining 
to home health. 

There is no doubt that a journal of this kind, if rightly 
conducted, is something that is much needed, and can be 
made the instrument of vast good both to the medical 
profession and the pul^lic. 

Our plan is to make it technical and scientific enough 
to satisfy physicians, yet plain enough for the public. 

Dr. R. J. Curtiss of Joliet, 111., Professor of Hygiene 
and State Medicine in the College of Physicians and Sur- 
geons, Chicago, will be chief editor, while the various de- 
partments will be conducted by persons of experience and 
ability. That there is a demand on the part of the public 
for instruction in this field is sufficiently proven by the 



418 The Peoria Medical Monthly. 

avidity witli which newspapers (the best weathervanes of 
paltlic sentiment) print everything that they can find 
npon such subjects. Much, however, that is so printed and 
scattered abroad, is written by persons with very little 
knowledge upon tiiese subjects, and this is liable to do 
harm. Could this kind of literature be supplied by those 
who are capable of giving the best, the good that could be 
accomplished would be incalculable. 

Our plan calls for a full elucidation of the sciences 
which relate to life, its improvement and preservation;* 
to educate the people to a proper appreciation of the ser- 
vices of educated physicians; to put the public on their 
guard against quackery, patent medicines, adidterations of 
food; to instruct the people in the art of nursing the sick, 
preparing proper food for invalids in a proper manner; in 
short, to instruct them in everything relating to home 
health. 

We believe a journal of this kind will occupy a hitherto 
unoccupied field, and will be worthy the support of phy- 
sicians as well as the public. 

Our prospects for success are very flattering, and we 
believe we shall succeed. The same policy that has in no 
small degree contributed to the success of the Peoria 
Medical Monthly will be applied to the new enterprise, 
viz : to give the most of the best going for the least money. 

The new journal will consist of 48 pages monthly, of 
the same size as this journal. The price will be |2.00 a 
year, or $1.00 to subscribers to the Peoria Medical 
Monthly. We would be glad to hear from any of our 
readers on this subject, giving their views and opinions, 
and to what extent they will assist in the work. 



A Physicians' Supply Conipauy. 

One argument urged against our paper of a year ago 
(on the advisability of physicians furnishing their own 
medicines) was that few wholesale houses would sell to 
physicians at all, fearing the effect it would have upon 
their druggist trade, and that few houses would sell to 
physicians in small quantities as they would wish to buy. 
We replied that if there was much demand on the part of 



Editorial Department. 419 

phj^sicians for drugs for their own dispensing, firms would 
be formed whose sole business would be to furnish them 
with just what was wanted. We are happy to note (and it 
seems as if it was a proof of the value of our argument) 
that a firm will soon be ready for business in this city whose 
sole business will be to sell to physicians everything that 
may be called for. 

Messrs. M. W. Schulz & Co. will open a physicians' 
supply house about the first of April. They have pur- 
chased the large instrument business of Colburn, Birks 
& Co., and in addition will make a specialty of selling to 
doctors the best and purest drugs in the market. We are 
personally acquainted with the gentlemen comprising this 
firm, and can assure our readers that every promise made 
by them will be faithfull}^ carried out. 

We write thus strongly upon the subject, not because 
we have been asked to do so, for we have not, but because 
we believe it will be of value to many of our readers to 
know that there will soon be such a house, where their 
wants, especiall}^ in the drug line, can be supplied. 



Notes and Coimiients. 

Dr. Frank L. Hinsdale (Rush '81) has removed from 
Gray, Iowa, to Toledo, Tama County, Iowa. 

Dr. A. T. Darrah, Tolono, 111., President of the State 
Medical Society, paid us a pleasant visit a few days ago. 

Dr. C. L. Jackson of Cincinnati, Neb., is attending 
another course of lectures at the Kentucky School of Med- 
icine, Louisville, Ky. 

Toledo, Ohio, has a new Medical College. Tickets 
$40.00, and requirements equal to the lowest tolerated by 
professional opinion. 

Philadelphia is to have a Post-Graduate Medical Col- 
lege, Baltimore a Polyclinic or two, and several other 
" centers " still to hear from. 

Oliver Wendell Holmes, Jr., son of the renowned Dr. 
0. W. Holmes, has been recently elevated to the Supreme 
Bench of the State of Massachusetts. 



420 The Peoria Medical Monthly. 

The Illinois State Board of Health is engaged in re- 
vising the Official Register of Physicians and Midwives for 
publication. All changes of address and other corrections 
should be promptly sent to the Secretary at Springfield. 

We notice in the daily papers that Dr. Wheeler, of 
Decatur, 111., a iDrominent eclectic physician and late Presi- 
dent of their State Society, has been acquitted of the 
charge of " abortion," for which he has lately been on trial. 

Dr. A. T. Bryan (Rush '82) was married Dec. 27, to Miss 
Ella L. Waite of Egan, Moore County, Dakota, where the 
Dr. is gaining a fine practice. The good wishes of the 
Monthly are heartily tendered to the young Dr. and wife. 

Dr. H. G. Murdock (Rush '81) has removed from Glen- 
wood, Minn., to Taylor Falls, Minn., where he has bought 
the property and practice of his brother. Dr. A. J. Murdock. 
Dr. M. is crowing over the arrival of an heir. Congratula- 
tions are in order. 

The College of Physicians and Surgeons, Chicago, has 
advanced their fees for 1883-84 to $50.00. This is a step 
in the right direction, but not a very long one. We hope 
the next year they will take a good long jump and place 
this college (a good one) beyond the possibility of being 
called one of the cheap ones. 

Secretaries of medical societies in the State of Illinois 
are requested to forward lists of the officers and members 
of such societies, with postoffice addresses, to the Secretary 
of the State Board of Health, at Springfield. These 
addresses are required to facilitate the distribution of the 
publications of the Board and for other purposes. 

An extraordinary security was offered by a man who 
recently advertised in a Berlin newspaper for a loan. The 
advertisement ran as follows: "A medical student whose 
means are exhausted would like to meet with some one 
who would advance him the necessary sum to complete his 
studies, at a moderate rate of interest. If necessaiy he 
would as a guarantee at once marry his creditor's daughter, 
or, if he prefers it, would give an undertaking to do so on 
passing his final examination. 



Editoeial Department. 421 

A correspondent to the Philadelphia Medical Times, 
writing from Chicago, says: " The general standard as re- 
gards educational fitness and preparation in Chicago, is 
below that aimed at by most of the schools." It is now 
time to hear from Cincinnati, St. Louis, Detroit, Louisville^ 
New York, etc., and see if the same may not be said con- 
cerning all of them. 

HOMCEOPATIIY. 

" Old Dr. Hahnemann read the tale, 
(And he was wondrous wise.) 
Of the man who, in the bramble-bush. 
Had scratched out both his eyes 

And the fancy tickled mightily 

His mystic German brain, 
That by jumping into another bush, 

He got them back again. 

So he called it " home-hop-athy," 

And soon it came about. 
That a curious crowd among the thorns 

Was hopping in and out. 

Yet, disguise it by the longest name 

They may, it is of no use ; 
For the world knows the discovery 

Was made by Mother Goose." 

A correspondent to the Medical Herald writes as fol- 
lows concerning a well-known Philadelphia college : "As 
to turning out good doctors, this college goes on the quan- 
tity plan rather than the quality. Short term, many lec- 
tures, two sessions only, cramming, easy green room and a 
flowery commencement, will stick to the Jefferson Medical 
College as long as it pays.'' 

The increased strength in the opium preparations of 
the new pharmacopoeia will give rise to considerable trouble 
unless the prescriber knows what the druggists are going 
to do. We suppose they will use up what they have already 
on hand of the old formulge, and then change to the new ; 
in the meantime and until it is generallj" known by phy- 
sicians that all druggists have these articles of increased 
strength, it would be well for physicians to signify whether 
each prescription be prepared according to the formula? of 
the old or new pharmacopceia. 

Dr. George M. Beard, the well-known neurologist, died 
suddenly, January 23, aged 44 years. His last illness be- 
gan with an alveolar abscess, i^leuro-pneumonia developed 



422 The Peoria Medical Monthly. 

in a day or two and he died after an illness of only four 
days. Shortly before he died he made the following re- 
mark, which was almost his last: "I w^ish it were possible 
for me to record for the sake of science, the thoughts of a 
dying man. This final battle that I am going through 
would be interesting." Since writing the above, word has 
reached us of the death of Mrs. Beard. January 31, of 
pneumonia ; united in life, death could not long part them. 

The Medical Age has an editorial in a late issue on the 
medical advertising agent. It puts some sober truths 
in a wholesome manner, and suggests the subject as a topic 
for the consideration of the Medical Journal Association at 
its next meeting. We have not been beset by many of these 
gentry, or had any trouble with them. The reason has 
been that we have refused to have anything to do with 
them, unless they accede to our terms. We believe in 
doing business directly with the advertiser, and lose no 
opportunity of convincing them that they get better rates 
by dealing directly wath us. We hope the subject will be 
fully discussed and settled by our contemporaries. 

Receipts for January. 

Illinois— Drs. W. H. Byford, D. AV. Scott, R. Sager, C. K. Hendee, L. A. 
Fisher, J. A. Harvej', l\. ^N . Bower, W. E. Gillilaud, M. P. Phinney ($1.50), 
W. R. Nash, E. ]M. Taylor, W. H. Conibear, A. M. Pierce, R. P. Jennings, G. L. 
Corcoran, J. F. McAnally, S. B. Bennett, ^\. H. Eldred, F. A. Darling, H. H. 
Littlefield, A. T. Bartlett, E. R. Boardman, W. H. Caulk, W\ G. Piersol, R. T. 
Henry, J. R. McCluggage, A. W. Hurd, A. J. Miller, Z. Allen (2 years), E. H. 
Graves (3 years), H. S. Bell, W. R. Mizell, E. H. Henry, H. Wardner, J. K. 
Welch, L. B. Martin (2 years), T. H. Stettler, ^\. C. Gaston, H. J. Birney, E. H. 
FeiTis, A. R. Graham. 

Iowa— Drs..E. N. Woodworth, J. B. Wilson, J. C. Corselius, M. I. Powers, 
E. S. Carlisle, Perry Engle, B. F. Hyatt, AV. G. Dwyer, Emil Brendel, E. C. 
Chapman, Frank L. Hinsdale, H. Newell Sill. 

Kansas — Drs. Hoover & Porter, A. M. Kirkpatrick, T. Arthur Wright, Hugh. 
C. Gault, J. Jenks, F. S. Morton. 

Minnesota — Drs. N. A. Winslow, M.J:]. Bushey. 

Tennessee — Dr. J. A. Williams. 

Wisconsin— Drs. J. M. Adams, I. J. Bennett. 

Kentucky — Drs. T. E. Black, AA^ I. Moore, J.J. Rodman. 

Arkansas — Dr. W. W. Longley. 

Indiana — Drs. Jno. J. Thompson, R, Burns. 

Missouri — Dr. J. H. Fleming. 

Xew Mexico— Dr. R. S. Tenney. 



The Peoria 
MEDICAL MONTHLY. 



Vol. III. MARCH, 1SS3. No. 11. 



(?)ri(jiiuil (!;ommuuiatiansi. 



Art. I. — '• Hoft- Lard " the Sina Qua Noii for '' Scarlet Fever.'" By J. M. Holb^ 

M. D., Salem, Ohio. 

Some thirty-five years ago, we found in a Southern 
medical journal an article on the treatment of "Scarlet 
fever," by Doctor Merrill of South Carolina. Some time 
time after, say one or two years, a terrible epidemic of that 
dread disease made its appearance in Nortlieastern Ohio, 
where we were then located in the practice of medicine, 
and the disease was most fearfully fatal, often terminating 
the existence of the patient inside of twenty-four hours, 
and in fact some cases of very fat boys of three to five years 
fo age were fatal in a few hours. Indeed no rash was man- 
ifest until after the child was dead three to ten or twelve 
hours, the little one being stricken, as Dr. Marshall Hall 
of London says, with " cerebral conjestion " or " apoplexy." 

I was having a sorry time in the treatment of my cases 
but upon comparison was as fortunate as to loss of them as 
my other medical brothers around me. Yet it was serious 
indeed, sometimes losing two or three out of a family of 
five or six children, and even in some instances losing more 
than that. One day I had two boys very sick in the fam- 
ily of three. The other child, a girl of some four to six 
years, was not yet ill with the disease. The parents seemed 



424 The Peoria Medical Monthly. 

over anxious for fear the girl would go clown with it, and 
she being so full of flesh they seemed to think if she took 
it her death was a foregone conclusion. I suggested to her 
mother that if she was taken sick before I again visited 
them to get a saucer full of hog's lard, melt it and com- 
mence at her head and continue to the ends of her toes, 
greasing her all she could get to stick on her, then roll her 
up in a sheet — linen sheet if she had one — and put her in 
bed and cover her with blankets and other clothes to keep 
her warm, and in four hours grease her again the same way 
and cover her up as before, and continue this until I again 
visited the family. Upon my next visit I found the boys 
both very low indeed. The girl had been taken in the even- 
ing after I left. This visit was about noon the following 
day. T found her as I thought doing very well ; the lard 
had been as thoroughly applied and as often as directed, 
with plenty of cold water to drink as she was very thirsty. 
I gave her, in addition, the following: Spirits nitri dulcis, 
30 drops ; creosoti, 10 drops ; aquae, 2 ounces. Dose, a 
tablespoonful once in an hour, and ordered a tablespoonful 
of castor oil with 10 drops of spirits of turpentine given the 
following evening, and continue the lard as before directed. 
Result, in about four or five days the girl was comparatively 
free from fever, her skin looked as red as a boiled lobster, 
and she began to eat and made a good recovery in a few 
days. 

This being so successful, I again tried it with a like 
result, and for several years have never failed to have the 
most flattering results in all steps of the scarlet fever. 
The internal treatment was varied when other conditions 
were to be met. But the lard acting by inunction, the 
fever, as Dr. Merrill contended it did, spent itself upon the 
lard instead of the fat of the patient. Give it a trial and 
you will be pleased with it, and may save many patients 
more. 



Art. II.— a Difficult Labor and Fcetal Monstrosity. By B Daley, M. D,. 

Osage Mission, Kan. 

On the morning of the 27th inst.. Dr. Stedman called 
-at my house and asked me to go in the country some six 



Original Communications. 425 

and a half miles to assist him in a case of obstetrics. He 
told me he had been engaged all night with a woman at her 
second confinement and that the woman had then been 
three days in labor breech presentation, and that he used 
the forceps at various times through the night all to no 
effect. I arrived at nine o'clock on the morning of the 7th 
of February, 18S3. Upon examination found the breech 
well down in pubis with no contraction of uterus. Advised 
ergot, thinking I could deliver the woman easily bringing 
down a foot, but in vain. I felt tor a trochanter and in- 
troduced my long Hodges forcep, ene blade after the other, 
and locked, but forseps slipped, as with Dr. Stedman ; for 
three trials all slipped. You may imagine when the mon- 
strosity had three legs, three arms, and two well-developed 
heads. The three legs w^ere equally divided at the inferior 
part of one body like a three-legged stool, and what we 
would take for the hind leg was one femor and it divided 
into two legs from the knee down, and had two well-devel- 
oped feet, the toes fronting from the back of the other two 
legs, and feet in opposite direction, with anus in the center 
of the lower portion of the body, and no sex. The arms 
came out of the shoulders equally, being natural except the 
arm on one spine had two thumbs and four fingers. 
Both heads were well developed, with natural necks, both 
looking forward, wdiere both the cervical vertebra came to- 
gether into the first dorsal and formed one spine the bal- 
ance of the way to about the last lumbar on first and sec- 
ond sacral, where it ended in an acetabulum. This mon- 
strosity weighed fifteen pounds, and was of no sex. 

Reader, you may imagine the difficulty in taking this 
child through an ordinary sized pubis. The perineum 
was ruptured within one-fourth of an inch of the anus, as 
both heads had to come together, the mother of course 
being under the influence of chloroform. Up to date the 
mother is doing well. The monstrosity was not obtained 
by any of the attending physicians as far as T know. 



The Fluid Extract of Tomato is highly recommended 
in nursing sore mouth and cancrum oris. 



426 The Peoria Medical Monthly, 



Manual of Gynecology. By D. Berry Hart, M. D., F. B. C. P. E., and A. H. 
Barbocr, M. a. B. Sc. M. B. Vol, I, with 8 plates and 192 cuts, 8vo., cloth ; 
314 pages. Wm. Wood & Co., New York. 

This is the initial volume of ll'oor/'^ Lihranj of Sfaii- 
(hird Medical Authors for 1S83, In appearance and make- 
up it is an improvement over the Library for the past year, 
and reaches a high mark as a sample of elegant book- 
making. The volume is certainly proof that the efforts of 
the publishers in the past have been dul}^ appreciated and 
have incited them to still greater efforts for the future. 
The quality of the paper is superior to that employed in 
previous series, and the binding is more substantial and 
durable. We are confident that the new series just begun 
will be heartily subscribed for by all who have taken the 
Lihrarij in the past, and will add to their already large 
subscription lists. 

A Manual of Gynecology, By D. Berry Hart, :M. D. F, R. C. P. E., and A. H. 
Barbour, M. A. B. Sc. N, B. Vol. II: with one lithograph and 210 wood 
cuts. 8vo. Pages 3(30 : with full index. Wm. Wood & Co., New York. 

Under the notice of Vol, I„ written for the last issue 
of this journal, but not printed for lack of space, we gave 
oui" attention to the external ap])earance of this work. It 
now remains to notice briefly the scope and character of 
its contents. It is essentially and in tact a manual, 
based, as claimed by the authors, on the anatomy, physi- 
ology and pathology of the pelvic organs, and as such treats 
in detail of all the minutise of the entire subject. 
The anatomy of the parts, instruments, methods of ex- 
amination, operations, and everything given with that 
regard for little things which is most desired by the general 
practitioner. The literature of each subject receives its full 
share of attention, and the bibliography is peculiarly full. 
With all the multiplicity of works on tliis subject we know 
of no single one which will satisfy the non-specialist as 
well as this one. 

Transactions of the Thirteenth Annual Session of the 3Ie(lical Society of Vir- 
ginia. Held September 13, 14 and 15, 1882. With an index for wlume 3 
Richmond. J. AV. Fergusson & Son, printers. 

Dr, H, M, Taylor of Richmond makes an able report on 



Book Notices. 427 

Drainage in Gunshot Wounds. The conclusions he arrives 
at are as follows: 

1st. That primar}^ adhesion is exceedingly exceptional 
in gunshot wounds. 

2d. That suppuration, granulation and cicatrization 
are invariably combined in the process of repair. 

3d. That extensive accumulation and burrowing of 
pus in a deep, narrow bullet track is to be expected and 
feared. 

4th. That the deep, narrow, angular and frequently 
obliterated track does not afford proper drainage. 

5th. That in such cases the principles of surgery ap- 
plicable to other deep-seated suj^purations must be ap- 
plied. 

6th. That position, incision, drainage tubes and the 
other means mentioned are of great importance in treating 
gunshot wounds. 

7th. That by nature's efforts, analogy and reason, we 
are taught to think that their more frequent use will lead 
to better results in this class of injuries. 

8th. That the danger incident to their use is far out- 
weighed by the benefit which accrues. 

The ex-President's Surgical Prize was awarded to the 
same gentleman for an essay on Recent Progress in Abdom- 
inal Surgery. 

Dr. S. K. Jackson, of Norfolk, Va., reported some rare 
and interesting cases of hystero-epilepsy or hystero-cata- 
lepsy. 

Dr. Bedford Brown, of Alexandria, read a valuable 
paper on the Pathology and Treatment of the Pneumonia 
of Early Infancy. 

The following prescription, which was administered to 
an infant three weeks old suffering from a severe pneumo- 
nia of both lungs, and which recovered, outlines his treat- 
ment : 

R L'i'j:. ammon. acetat, 3 drachms. 

Tr. belladonna, 12 drops. 

Tr. digitalis, 12 drops. 
Spts. ammon. aroraat, 1^2 drachms. 

Vini ipecac, 16 drops. 

Aquse, 10 drachms. 
Syr. Acacia. 6 drachms. M 



428 The Peoria Medical Monthly. 

Teaspoonfnl every three hours. In connection with 
this, he ordered a warm mustard bath every four hours^ 
followed with brisk friction with dry flannel. A few drops 
of brandy with each dose of the mixture, and small, dry 
cups over the dorsal portion of the chest. 

There were several other papers presented of real 
merit, but lack of space forbids further notice. 

Transactions of the Medical Association of the State of Missonri — 25th An- 
nual Session. Held at Hannibnl, May 16, 17, 18, 1882. Paper, 220 pages. 

The first impression on looking over this volume is 
that such a book deserves a cloth binding, and we hope, 
should this come to the notice of aii}^ member of the Pub- 
lication Committee, that he will suggest it for the next vol- 
ume. 

The President's Address, by Dr. Willis P. King, of Se- 
dalia, on Quacks and Quackery in Missouri, is a startling 
revelation, and should be used as an overwhelming argu- 
ment before the Legislature of that State in favor of the 
establishment of a' Medical Board of Examiners for the 
State. Two" hundred and sixty-nine persons are known to 
be, or are suspected of producing abortions; 1,904 are con- 
sidered by competent judges to be incompetent to practice 
medicine; 5,570 deaths occur annually in consequence of the 
neglect, ignorance and incompetence of these unworthy 
practitioners. Quacks collect nearly $2,000,000 each year^ 
for services which are for the most part valueless, and 
often extortionate. The address should be read by every- 
body. Among many interesting papers we have only 
space to mention a few. Railroad Surgery, by Dr. J. M. 
Trader, Sedalia; Vaginal Injections, by Dr. P. V. Schenck, 
St. Louis; Degeneration of the Thyroid Gland, by Dr- A. 
W. McAllister, Columbia; Neurathophia, by Dr. C. H. 
Hughes, St. Louis; Idiopathic Sub-iVcute Laryngitis, by Dr. 
W. C. Glasgow, St. Louis: Sulphate of Quinine, Its Use and 
Abuse, by Dr. G. M. Dewe}^ Keytesville, and Local Medical 
Organizations, by Dr. T. S. Norris. 

Pocket Tlierapeiitics and Dose Booh: With Classifi- 
cation and Explanation of the Actions of Medicine ; 
Minimum and Maximum doses in Troy weights, with 
their equivalents in the Metric weights ; genitive end- 



Book Notices. 429 

ings of all medicines and preparations given in italics ; 
index of common and pharmaceutical names ; index of 
diseases with appropriate remedies ; tables of solubilities ; 
illustrations and examples in prescription writing ; poisons, 
their symptoms, antidotes and treatment : incompatibles 
and antagonists ; useful hints to the prescriber, etc.. etc., 
etc. By Morse B. Stewart. Jr. Third Ed. ; vest pocket 
size ; cloth ; 240 pages. In cloth $1.00 ; Morocco $1.50. 
(t. D. Stewart & Co., Detroit, Mich. 

Naso- Antral Catarrh and Its Treatment. By W. H. 
Daly, M. D., Pittsburgh. Pa. Reprinted from Archives of 
Laryngology, October, 1882. 

Addresses. Delivered on the occasion of the dedication 
of Cooper Medical College Building. By Levi C. Lane, M. 
D., and Edward R. Taylor. 

The Therapeatic Value of CephaHc and Spinal Electriza- 
tions. By C. H. Hughes, M.' D. 

Bights of Insane. By the same. 

Some New Experiments in Muscle Beading {thought read- 
ing) By Ct. M. Beard, M. D. Reprinted from the Alienist 
and Neurologist. 

Address in Surgery. Excisions of Portions of the 
Alimentary Canal Covered by Peritoneum. By W. A. Byrd, 
M. D., Quincy, 111. Reprinted from Transactions of the 
American Medical Association, 1882. 

Abdominal Section in the Treatment of Ulceration and 
Perforation of the Cwcum atid the Appendix Vermiformis. 
By Wm. A. Byrd, M. D., Quincy, 111. Reprinted from Tran- 
sactions of the American Medical Association, 1881. 

Civilization Not the Cause of Tooth Decay. An Essay. 
By John J. R. Patrick, D. D. S., Belleville, 111. Read before 
the Illinois State Dental Society at Quincy, May 10, 1882. 
Reprint from the Society's Transaction. 

Quarterli/ Compendium of Medical Science, January, 
1883. Edited by D. CI. Brinton, M. D., and Joseph F. Ed- 
wards M. D. This is the well knowai Compendium of Medi- 
cal Science, published as a quarterly, instead of half-yearly, 
as heretofore. The excellence of the publication needs no 
commendation at our hands. Price 2.50 a year. 



430 The Peoria Medical Monthly. 

Suicides in New York Cifi/ D}(r'nuj flie Eleven Years, End- 
ing Dec. 31st, 1880. By J. T.'Nagie. M. D. Read before the 
American Public Health Association at Savannah. Ga., 
1881. 

The San ifarian. Devoted to the Preservation of Health, 
Mental and Physical Culture. Dr. A. N. Bell. Editor. 
$4.00 a year. This publication stands at the head of the 
Scientific Sanitaiy Journals of the Country, and should be 
read by all interested (and v^lio are not ?) in this subject. 



^tx'mo\u. 



A Brief Treatise on Therapeutics. 

ASSIMILATION AND EXCRETION. 

It is very important for success in treatment that the 
student have soii:e good broad views as to assimilation and 
excretion, for, after all, sound physiological knowledge is 
the basis of the practice of physic. Let us consider diges- 
tion first. Digestion is essentially a process of solution. 
Our food is stored up in insoluble forms, else a steady rain 
might imperil much of animal life. Starch, then, is con- 
verted into sugar by a process of hydration (that is, the 
adding of a molecule of Avater) under the influence of the 
ferments of the saliva. This sugar, being soluble, is ab- 
sorbed from the alimentary canal into the blood, and then 
reconverted back in the liver into glycogen, or animal 
starch, by the removal of a ifiolecule of water. This glyco- 
gen is given off as required into the blood as sugar, and is 
burnt by oxidation, and is largely the fuel-food of the 
bod}^ 

Then the tissue-feed, which is albuminous, whether as 
albumen, fibrin, casein, or legumen, is digested by the gas- 
tric juice with its ferment, pepsin, and is also dissolved by 
a process of hydration, in which the highly insoluble "pro- 
tied" is converted into highly soluble "peptone," which 
readily passes through the wall of the alimentary canal 
into the blood. Here it is again passed back into a "pro- 
tied" by the removal of a molecule of water : without such 
change the peptone would as easib^ escape out of the blood 
as it passed into it. From these albuminoids the tissues 
are made in growth, and repaired in adult life. 
Fat is saponified to some extent by the bile, emulsionised 



Periscope. 431 

by the secretion of the pancreas, so that it is taken up by 
the lacteals of the intestinal villi, and thus is brought into 
the system. Fat is not only fuel-food, but is essential to 
the formation of healthy tissues. 

But for solution "disintegration'" is essential. Before 
either starch or albuminoids can be dissolved by hydration, 
they must be finely divided or disintegrated. For this end 
our teeth are provided. The food taken into the mouth is 
masticated and rolled about in the mouth by the tongue, 
and mixed with saliva, so that the starch is converted into 
sugar. This action of the saliva ferment, or diastase, _ is ' 
arrested as soon as the contents of the stomach become acid. 
Can we do anything to aid this part of the digestive act 
when imperfect ? Sialogogues. or" agents which increase 
the flow of saliva, are not a very important class of thera- 
peutic agents. All tasty or sapid substances excite a flow 
of saliva, but the medicinal sialogogues are not many. Pel- 
litory. jaborandi. and mercury are all sialogagues. but are 
not used as such to excite the flow of saliva for the conver- 
sion of starch into sugar. For this end we use artificial 
diastase, or maltine, produced in malting barley. This fer- 
ment, diastase, converts the starch into sugar. And is now 
largely used in the feeding of delicate children. It should 
be added to the milk and gruel before it is taken into the 
mouth, not given after a meal, to be at once killed by the 
acid contents of the stomach. 

Then as to the digestion of albuminoids. Such forms 
of albuminoid matter as fall readily to pieces in the stom- 
ach, are more digestible than those which are disintegrated 
with difficulty. Thus, loosely-fibred fish, as whiting, is 
much more digestible than close-fibred beef-steak. AVhere 
there is much pain produced by the digestive act, the food, 
when solid, should be such that it is readily disintegrated. 
Pastry and closely-filjred meat should be eschewed. False 
teeth, if necessar3^ patience in the act of mastication, and 
properly selected food, are the means by which we seek to 
furnish relief when the mechanical obstruction to the diges- 
tive act is the source of trouble. 

Then as to the solution of albuminoids. We do not 
always attempt to directly stimulate the secretion of gas- 
tric juice, though many agents will affect that secretion, 
but now commonly use pepsin procured artificialh^ from the 
calf or pig. But we ma}' combine these measures. The 
agents which increase the flow of gastric juice are called 
stomachics. They increase the vascularity of the stomach 
and stimulate the flow of gastric juice. Such agents w^e 
possess in alcohol and arsenic, each of which produces in- 



432 The Peoria Medical Monthly. 

flammation of the stomach iu toxic doses. Ipecacuan pro- 
duces this vascularit}^ in small doses, but excites vomiting 
in large doses. An old dinner pill ran : 

Pulv. ipecacuan, 1 grain. 

Ext. eiuchouje, 1 grain. 

Pil. al. et mj'rrh, 2 grains. 

Ringer tells you that an alkali will stimulate an acid 
secreting surface, consequentl}^ alkalies may be given be- 
fore meals, thus : 

Pot. bicarb, 6 grains. 

Fowler's sol, 1 minim. 

Inf. gentian, 1 ounce. 

Here there is combined the alkali with arsenic in a bitter 
vehicle. 

BITTEES. 

We do not know the action of bitters, but w^e know 
well empirically that bitters increase the appetite and im- 
prove the digestion. Those containing tannin, as gentian, 
chiretta, or chinchona, etc.. should not be given along with 
iron, as they form a tannate of iron (ink). Quassia is the 
bitter to give with iron. Quinine is to be used with iron, 
and not cinchona. 

Then as to the use of artificial pepsin, w^hich can now 
be procured in various forms. Given immediately after 
food, pepsin preparations add considerably to the solution 
of albuminoids when the gastric juice is defective in quan- 
tit}^ or in solvent qualities. Such. then, are the means by 
W'hich we effect the digestion of albuminoids. 

Then as to fat. Fat, in the forms of fat, oil, and but- 
ter, is not acted upon by the saliva, nor j^et by the gastric 
juice. When the contents of the stomach are thrust through 
the pyloric ring into the gut, they come in contact with the 
bile, and the bile acids saponify the fat. Oil will not run 
through filter paper, but when that filter paper has been 
moistened with bile, then the oil passes through the paper 
readily. A process of sub-division equal to disintegration 
goes on with fat before the pancreatic secretion emulsiou- 
ises it, so that it can be taken up by the lacteals. Can w^e 
do anything to aid this digestion of fats when defective ? 
We can, by seeing that the fat is in a state of fine sub-divis- 
ion before it is eaten. Thus, butter well rubbed into stale 
bread, cut thin, is much more readily digestible than when 
spread in a thick layer, a fact never to be forgotten when 
delicate children are to be dealt with. Then fats vary in 
digestibility. Cod-liver oil is the most digestible of all fats, 
and can often be assimilated when the digestive powers are 
unable to digest other fats. Then come cream or butter, or 



Periscope. 433 

pig fat ; solid mutton or beef suet requiring the strongest 
digestive powers. Agents which increase the flow of bile, 
as ipecacuan, or sulphate of soda, aid materially in the as- 
similation of fat ; the first may be given in pill as above, 
the other added to the patient's bitter mixture in half 
drachm doses. 

Sol. sulphat, 3^ drachm. 

Ac. ]Sr. mur. dil, 6 minims. 

Inf. gent, 1 ounce. 

will olten be found a useful combination in simple loss of 
appetite with impaired digestive power. We can also 
stimulate the pancreas by the administration of sulphuric 
ether. The pancreatic secretion not only emulsionises fats, 
but, in an alkaline medium digests albuminoids, and con- 
verts starch into sugar. Consequently we give artificial 
pancreatic preparations at the end of the digestive act, to 
aid the defective action of pancreas, when indicated. 

ARTIFICIAL DIGESTION. 

The digestion of food out of the body is now readily 
attained by the use of preparations of the pancreas of the 
pig. Milk and water, or milk-gruel, can be digested by 
pancreatic solutions in the proportion of one pint to a tea- 
spoonful of liquor pancreaticus (William Roberts), and ten 
grains of bicarbonate of soda (in solution). Raised to a 
temperature not exceeding 150 degrees Fahrenheit, the 
nearer this the better, and put under a "cosey" for an hour, 
digestion is then nearly complete. Such artificially digest- 
ed food is indicated in typhoid fever, gastric catarrh, gas- 
tric ulcer and cancer, and in all conditions of acute debility, 
especially when curd from plain milk, is found in the 
stools. 

Then assimilatiou can never be properly carried on if 
the bowels are loaded. Consequently always attend to the 
bowels. Keep them open by laxative pills as Pil. Col. Co. 
at bedtime, and, if necessarj^ a seidlitz powder, purgative 
waters, Carlsbad salts, or, better still, sulphate of soda and 
Rochelle salts (Sod. Pot. Tart.) combined in a warm bitter 
solution. In delicate persons, in all elderly persons, and in 
women at the change of life, care must be taken to see 
that the laxative does not gripe, and this may be done by 
adding a carminate, as Pulv. Piperis Nig. 2 gr., to the Pil. 
Col. Co. 2 gr.; or tincture of ginger to the morning mixture. 
A glass of cold water first thing in the morning will often 
suffice to regulate the bowels. Hyoscyamus is often added 
to the night pill to relieve griping (1 gr.) — Dr. Fothergill in 
LeonanVs Ilhistrafed Mo nth 1 1/. 



434 The Peoria Medical Monthly, 

The Value of Cannabis Indica in Checking Epistaxis. 

Dr. W. G. Maxwell, of Still Pond. Md., sends the follow- 
ing commnnication: "The recent attack of epistaxis from 
which Governor Hamilton (of this State) suffered prompts 
me to call the attention of the medical profession to the 
above-named drug, which has acted like magic in checking 
epistaxis during the seven years I have been using it. 

I have had nine cases of profuse epistaxis (where plug- 
ging the nares seemed to be the only alternative) that 
were checked by Indian Hemp in from three to twenty 
minutes. Xor was there a recurrence of hemorhage in a 
single case. 

I have prescribed it for a number of other persons 
subject to bleeding at the nose, who derived the same bene- 
fit from it. 

I use the tincture in ten to twenty drop doses, repeated 
every five to ten minutes. The largest quantity given was 
fifty drops in three doses, to a gentleman wdio had been 
bleeding ten hours: the hemorrhage ceased in twenty 
minutes after the first dose was administered. 

The Cannabis Indica was used alone in these cases^ 
there being no other internal or local treatment. 



Recent Progress in Dei-niatology. 

Wcais and corns are so frequently a source of discom- 
fort or pain to those unfortunate enough to possess them 
that any remedy which promises to remove them, short of 
the knife, caustic, or actual cautery will doubtless be warmly 
welcomed by the profession. At the last meeting of the 
American Dermatological Association {Med. Chronicle, Oc- 
tober, 1882), Dr. Jas. C. White gave an account of a very 
successful experience with the following remedy: 

I^ Acidi salicylici, i.> drachm. 

Ext. cannibis, 10 grains. 

Collodii, 1 ounce. 

This is YJaiuted on the corn or wart in successive coats 
at short intervals until three or four layers are applied. 
The next day the growth can be easily sci'aped oft'. The 
reporter has tried this in several cases of corns with good 
effect. Care should be taken not to make the application 
to the sound skin, as it sometimes causes an unpleasant 
degree of irritation. 

Una {Monatsheffe f. prald, Derniatoloyie, May, 1882), 
speaks highly of the value of the application of an arsen- 
iated mercurial plaster in destroying warts. This is applied 
continuously, and, in a few days, the growths become flat- 



Periscope. 435 

tened, yellowish white in color, and in the course of a week 
or two disappear entirely. No sloughing of the warts takes 
place, but they undergo gradual absorption. The applica- 
tion used by Unna contains from five to ten per cent, of ar- 
senic. The combination may be made as follows : 

5 Acidi ai-seniosi, 12-24 grains. 

Uno;t hydrargyri, 34 ounce. M 

ft. Ungt. 

This is to be spread on muslin or adhesive plaster and 
applied to the parts containing the warts. It should be 
kept applied constantly, or at least at night. It would be 
well, however, in using this to guard against absorption of 
mercury. 

The fyeatment of Alopecia Areata is generally very un- 
satisfactory. Yidal and Fournier apply vesicating plaster 
every two or three days on the bald spots. After two or 
three applications, it is said the disease does not progress. 
The vesication is kept up until strong hairs begin growing. 
When this point has been attained, tincture of cantharides 
is rubbed into the patches twice daily with a stiff brush. 
If the region of the beard is afi'ected, daily shaving should 
be practiced in addition to the cantharidal applications. 

Michelson. w^ho refers to the above method, gives his 
own practice in these cases. He used salt-w^ater baths (5 
per cent, common salt in the bath), of a temperature of 95 
and 97 degs. F. The baths are taken three times a week, 
the patient remaining in the bath for twenty-five minutes. 
While in the bath, the diseased patches are rubbed w^ith a 
flannel rag dipped into the salt solution. Twice a w^eek 
the faradic current is passed through the affected skin, 
using the electric brush as electrode. The sittings last ten 
minutes. On those days on which no days are taken the 
diseased patchs are to be rubbed with a somewhat stronger 
salt solution. Good food, and, if necessary, tonics are to be 
given in addition. 

Pruritus ani is one of the most troublesome of the mi- 
nor affections that sometimes anoy people. According to 
Dr. N. L. Folsom (Mich. Med. News, Oct. 25, 1882), the es- 
sence of peppermint, repeated as often as necessary, gives 
relief when applied directly to the part. He also advises 
an ointment of alum, and bathing the parts with cold water 
on retiring for the night. 

Epithelial cancer of the skin has been successfully 
treated by Dr. W. A. Collins {Cin. Lancet cmd Clinic), July 
15, 1883), according to the following plan : Ergot ground 
to an impalpable powder was applied thickly to the ulcer 
three times a day, the ulcer being thoroughly washed once 



436 The Peoria Medical Monthly. 

daily. The powder was applied dry. After each applica- 
tion the ulcer was covered with a muslin rag wet w^ith the 
following lotion : 

IJ Acidi carbolici, 1 drachm. 

Acidi sulphurosi, 4 drachms. 

Glycerini, 1 ounce. 

Aqua?, 2}y^ ounces. M 
Sig. Lotion. 

Quinine, iron, cod-liver oil, and other roborant rem- 
edies, were also given. 

/;/ yhiis poisoning, the itching and burning are markedly 
relieved, according ito Hardaway {St. Louis Courier of Med- 
icine), by a solution of sulphate of zinc, half an ounce in a 
pint of water, to be applied every hour during the day, and 
several times during the night. In some cases the erup- 
tion' is aborted in two days. In no case has he found it 
necessary to continue this treatment beyond four or five 
days. 

Superficial e.rfolicition of the fon(/ueha,>i recently received 
considerable attention, especially from Fairlie Clarke, Cas- 
pary, Ilnna, Parrot and Clautier. The results of these re- 
searches are summarized in the Monafsheffe fuer Pralischie 
Dennafolor/ie, Nos. 2 and 7, 1882. The clearest description 
is given by Clarke, the latest writer on the subject, in the 
following words: "A circumscribed patch of the lingual 
epithelium assumes a white, opaque appearance, as if it had 
been pointed over with a solution of nitrate of silver. The 
details of the papillary structure are lost, and the area is 
merely mapped out with a few delicate ramitying grooves. 
This appearance is due to a slight accumulation of the 
epithelium, which l^ecomes infiltrated and matted together 
into a smooth and almost uniform surface. The cause of 
it, no doubt, is a slight inflammation in the deeper layers 
of the mucous membrane, which interferes with the vital- 
it}" of the epithelium. After the kipse of a day or two, the 
epithelium is detached from the subjacent mucosa, and is 
thrown off. either in the form of minute particles or of 
larger scales. If appropriate treatment is adopted, or even, 
I ])elieve. without any treatment at all (at least in the ear- 
liest stages of the disease), the epithelium is speedily re- 
stored ; so that it may be difiicult to tell where the exfo- 
liation was situated. But ere long another patch turns 
white and opaque, and goes through the same series of 
changes ; and thus the disease progresses. The exposed 
mucous membrane looks raw and of a deep red color, and 
the surface is slightly swollen. The inflammation in the 
deeper part of the mucosa seems to begin in a point, and 



Periscope. 437 

thence to spread in somewhat of a circular form, for the 
patches of the epithelial layer which are thrown off are 
very frequently of a rouud or oval shape. I have seen 
tongues in which this had gone on to such an extent that 
the whole surface was mapped out in patches, more or less 
circulai-, leaving slender bands of epithelium between them. 
Such tongues have a generall)^ red, raw look, and the bands 
of sound epithelium stand up from them with remarkable 
distinctness. After this patchy exfoliation has gone on for 
some time, it encroaches more and more upon the healthy 
epithelium, till at length the tongue is quite denuded, and 
the whole surface has an uniformly red appearance, with 
crescentic markings or depressions upon it." 

The affection so graphically described, Clark believes 
to depend upon inflammation affecting flrst the deeper lay- 
ers of the mucosa, and secondarily impairing the vitality 
of the epithelium. This inflammation he believes to be 
" the outcome of some constitutional irritation,'' which may- 
be dyspeptic, gouty, or syphilitic. 

The treatment consists in the removal of any constitu- 
tional cause that may exist ; locally, the tongue should be 
carefully dried and lightly touched with the solid nitrate 
of silver, or painted with a solution of the same. 

The prognosis, when the disease is advanced, is unfa- 
vorable. " Neither local nor constitutional remedies pro- 
duce any effect, and in many instances there is this further 
difficulty to contend with — an irritable digestion has given 
rise to an exfoliated tongue, and an exfoliated tongue ag- 
gravated the irritable digestion. Thus the disease pro- 
gresses in a circle, and progresses continuous!}"." 

[The waiter is unwilling to concur in this unfavorable 
prognosis of Mr. Clarke. In a case of considerable persist- 
ency and extent recently under treatment, the tongue as- 
sumed a healthy appearance after the administration for 
several weeks of the dilute nitro-muriatic acid in fifteen- 
drop doses thrice daily. Whether the disease has returned 
is unknown, as the patient has since removed from the city. 
The patient was a persistent smoker, and suffered, when he 
first came under treatment, from malarial fever contracted 
in the South. Restriction in the quantity of tobacco used, 
large doses of quinine, and the nitro-muriatic acid, resulted 
in a complete cure, temporarj^ at all events.] — G. H. Rohe^ 
M. D., in Med. Chrotiicle. 



The Proper Use of Ergot iii Obstetrics. 

Dr. Joseph Taber, of AYashington, D. C. read the fol- 
lowing paper on this subject at the last meeting of the. 



•438 The Peoria Medical Monthly. 

American Gynecological Association, which we take from 
the Boston Med. ami Surg. Jour. : 

The writer enumerated some of the many indications 
which from time to time since the introduction of this drug 
into obstetric practice by Dr. Stearns had been believed to 
exist for its use, as to hasten slow pains in first and second 
stage, to bring on labor, for threatened abortion, placenta 
praevia, etc. The action of the drug on the uterus was de- 
scribed as a persistent tonic contraction, finally becoming 
tetanic. All the fibres are equally contracted, whereas in 
a normal labor there is a repeated shortening and length- 
ening of the long fibres, while the circular ones are relaxed 
over the presenting part. If by chance the child is expelled 
under ergot it is because, everything being in readiness, the 
fundal muscles have contracted a little the first. The con- 
traction under ergot lasts for hours, and the child is com- 
pressed equally on all sides. Not only is the placental cir- 
culation, which ought to go on in the intervals of the pains, 
checked, but a strong pressure is brought to bear on the 
head and chest of the child, wl^ch by its continuousness 
may be fatal. Again, it is the intermittency of the con- 
tractions which prepares the passages for the transit of the 
child, and if they are not so prepared various ill effects, 
from a minute fistula to an extensive sphacelus, may result 
—these results being due more to continuity of pressure 
than to length of time. Moreover, the sudden expulsion of 
the fffitus through unrelaxed passages may cause all sorts 
of rupture from that of the uterus to that of the perinseum. 
Ergot is uncertain in its action, and may affect any part 
of the uterus solely, sometimes causing the hour-glass con- 
striction. 

To illustrate the large number of still-births ascribable 
to this agency, three cases were detailed, in each of which 
ergot was exhibited to dilate the cervix on the failure of 
uterine pains, from sixteen to twenty hours after the be- 
ginning of labor. In each case the child was known to have 
been alive at the beginning of labor, but all were still-born, 
and one had a brigiit red band, evidently due to restriction, 
about the head. 

Various authorities were cited among those who first 
sounded the note of alarm regarding ergot. In 1850 the 
Academy of Medicine of Paris appointed a commission, who 
reported the danger from compression and narcotism. In 
accordance with this report, three years later the Academy 
voted against its use, except in miscarriage, hemorrhage, 
etc. Subsequently Chapman showed that an " ergot-pain " 
was fatal to half the children if continued an hour. Thanks 



Periscope. 439 

to present medical instruction the administration of ergot 
to dilate the os is rather among educated physicians, but 
the large number of still-births reported by midwives, and 
the fact that they all carry their ergot bottle in their pocket, 
shows that much damage is done by this class of accouch- 
eurs. The writer thought that a few indictments for in- 
fanticide might have a salutary effect on these persons. 
The use of ergot was discussed and condemned in abortion 
with retained placenta, when it acted mischievously by 
locking up the secundines. As a routine treatment against 
post-partum hemorrhage it is unreliable, taking from fifteen 
to thirty minutes to act ; moreover, it often causes vomit- 
ing, and if the patient is weakened by hemorrhage it is not 
absorbed even if retained. Subcutaneous injection is the 
only method of administration which is reliable. In threat- 
ened abortion and accidental hemorrhage ergot is useless. 
With primipse it is dangerous. If dilitation is complete ia 
a multipara, the soft parts relaxed, there is no obstruction 
to the birth, and the attendant is sure that a few more 
pains are all that is wanted, he may give it cautiously, with 
the understanding that if the birth does not occur in a half 
hour the forceps shall be used. With this rare exception 
ergot should never be employed unless the uterus be empty. 
Viewing the use of ergot as a whole, the reader thought the 
race would be better off without it altogether. 



Piieumonia in Children. 



The Med. Press and Circular says that : M. Jules Simon, 
of the Enfants Malades Hospital, gives the following dis- 
tinctive characters of pneumonia and pleurisy in children : 
Pneumonia commences by a rigor, by vomiting, convul- 
sions, and a violent fever. There is no pain in the side ; 
the respiration is quickened, sometimes reaching 60 in the 
minute. There is a sort of tickling sensation in the throat, 
which makes the little patient cough incessantly, a little 
dry cough. During the tirst forty-eight hours the physical 
signs furnished by auscultation and percussion are nil, or 
nearly so. The only thing auscultation discovers in the 
first two days, is the absence of the respiratory murmur, 
and apnoea more or less pronounced. In pleurisy, on the 
other hand, there is no violent fever, no vomiting, no con- 
vulsions ; so that often acute pleurisy remains entirely un- 
suspected by the parents. They take the malady for a sim- 
ple cold, and at the end of seven or eight days the child is 
taken up. It is thus parents bring their children to the con- 
sulting room, little imagining the existence of a pleural effu- 



440 The Peoria Medical Monthly. 

sion. However, there is a sign that is not observed in 
pneumonia, and that is, pain which is not situated beneath 
the breast, as in the adult, but from some inexplicable 
cause, in the hank of the side affected. 

It is not an intercostal neuralgia, as in the pleurisy of 
the adult, a pain radiating in some of the nerve filaments 
of the alxlominal wall. In the child attacked with pleurisy 
there is but slight fever : he sleeps badly, the appetite is 
dimiuished, and he complains of a pain in the abdomen, a 
pain which should immediately direct the attention of the 
medical man to the probability of the existence of pleurisy. 
The respiration is but very slightly accelerated, and the 
cough a little diy, does not present any particular features. 
Twelve or twenty-four hours afterwards percussion will re- 
veal the existence of dullness, aud a certain hruit de frotte- 
ment will be heard by auscultation. The apncea will be ob- 
served to be more or less complete, and wdien the child 
cries a veritalde broncho-a?gophony will be perceived. The 
general condition of the cliild is so little changed that in 
most cases he can get up and go about as usual. As to the 
treatment of this last affection, M. Simon recommends dry 
cupping at the beginning and poultices. The next da}^ or 
the following small blisters, left on for three or four hours 
and, when taken off', another poultice applied and left on 
for an hour, when the blisters will have arisen and can be 
dressed. This revulsive treatment should be continued 
throughout the whole duration of the disease. As mixture 
he prescribes the following ; — Tinct. scillae, tinct. digitalis of 
each ten drops ; syrup, one ounce ; gum water, three ounces. 
A teaspoonful every two hours. The digitalis and the 
squills should be suppressed after four or five days. Milk 
should be freely given, as it acts as a good diuretic. 



Bismuth in Dyspepsia of Children. 

E. W. Dunbar, M. D., in the Practitioner, tor September, 
1882, saj^s: Loss of appetite in children with pain after eat- 
ing, nausea, and depression, if accompanied by a tongue 
either clean or slightly coated, but showing redness and en- 
largement of the papiilaee fungiformes, is quickly relieved 
by administration of bismuth, either in the form of the 
solution of the subnitrate or of the solution of the oxide in 
ammonia and citric acid, as discovered and x^repared by 
Mr. Schact. The dyspepsia, which is characterized by the 
described appearance of the tongue, is produced h\ indi- 
gestible food. If the tongue is coated, the dyspepsia is re- 
cent, and it is chronic and of some duration if the tongue 



Periscope. 441 

is clean — loss of appetite and consequent diminution in the 
amount of food taken having given opportunity for the 
tongue to clean. 

The digestion of children being easily disturbed, this 
form of dyspepsia may very frequently be observed among 
them. It is often necessary to persist in the use of bis- 
muth for several weeks before the papillae fungifbrmes re- 
sume their normal appearance and a lasting cure is effected, 
althrough improvement stops itself quickly in the appetite 
and returning liveliness and cheerfulness of the little pa- 
tient. The action of the bowels is, as a rule, markedly im- 
proved and more regular, especially if the liquor bismuthi 
is used ; exceptionally, the bowels are rendered more con- 
stipated, and it is necessary to give a mild aperient occa- 
sionally. 

. While testing the accuracy of the described indication 
for the use of bismuth, I prescribed it, owing to the state 
of the tongue, in the case of a child who had an obdurate 
cough that had resisted all the usual remedies for subduing 
irritation of the larynx. The cough ceased with the im- 
provement which quickly preceded the dyspeptic symptoms. 
The dullness and languor produced by this form of dvspep- 
sia in children may easily be mistaken, especially if the 
tongue is clean, for weakness and a condition requiring 
tannic treatment. The marked distaste for food and the 
characteristic tongue point to the true nature of the ail- 
ment. 

The dose of liquid bismuthi varies from two minims 
under one year of age to three, five, ten. fifteen and twenty 
minims up to twelve years of age ; the dose is to be re- 
peated twice or four times a day according to the severity 
of the symptoms. The remedy seems to be most effectual 
when taken after meals. The subnitrate may be given in 
doses of one-half grain up to two, three and five grains. 

Bismuth is quite ineffectual in the dyspepsia of chil- 
dren where the tongue is smooth, clean, and shows no en- 
largement or redness of the papillae fungifornies. 



Treatment of Puerperal Mastitis by Iodide of Lead Ointment. 

In the American JouDial of Obstetrics, Dr. Thomas T. 
Grant expresses his disappointment at the ill success of 
belladonna in checking the secretion of milk, but reports 
good effects from iodide of lead. He says : 

•'The breast being thoroughly dried and carefully 
cleansed, we smear its surface with the officinal ointment 
of the iodide of lead, and then gently rub it in until a con- 



442 The Peoria Medical Monthly. 

siderable quantity is absorbed: Soak a piece of sheet-lint, 
of a size sufficient to cover the breast, in the following solu- 
tion : Acetate of lead, from 2 drachms to i ounce to the 
pint, of one to four solution of alcohol. If we desire a more 
elegant preparation, eau de cologne may be substituted. If 
there be much pain it is often well to apply an ice-bladder 
upon the sheet-lint covering the breast. The lint should 
be frequently dipped in the lead lotion. The following 
phenomena will present themselves : First, a cessation of 
pain, fullness and uneasy feeling of distention, which is so 
annoying. It is common for the patient, who has been ex- 
hausted by pain and consequent loss of sleep, to fall into a 
refreshing slumber even after the application is made. In 
the course of three or four hours the breast may be com- 
pletely emptied by an experienced hand. The ointment 
should be used as a lubricant during the manipulation. By 
applying the iodide freely twice or thrice, daily, the secre- 
tion will be gone in less than one week, as a rule. The 
pivotal point in the treatment is the use of this ointment ; 
the evaporating cold being only adjuncts. I have proved 
by repeated trials that, wdien applied alone, it is capable of 
exerting an absolute control over the secretion. I believe 
we here invoke a specific action from the lead iodide. A 
point of considerable moment is the partial anaesthesia it is 
capable of inducing, which thus enables us to empty the 
glands, wdiere before, even slight pressure w^as badly borne. 
Its action, without doubt, extends to the epithelial cells 
and inhibits their secretory activity, as is seen in its action, 
in cases like the above, in causing the drying up of the se- 
cretions." — Boston Med. and Surg. Journal, Jan. 18, 1<S83. 



Treatment of Aineiiorrliea by Pei'iiiangaiiate of Potash. 

Dr. Sydney Ringer and Dr. William Murrell, of London, 
in the Lancet, say: We are desirous of calling attention to 
the value of a very simple I'emedy in a very common com- 
plaint. Our observations have extended over a period 
of thirteen months, and we have notes of sixty-nine 
cases. We hav^e used the permanganate in two forms, first, 
the pharmacopeial solution, and secondly, the permangan- 
ate, made into pills, each containing either one or two 
grains, (lenerally we begin with a grain three times, and 
then gradually increase the dose to two grains four times a 
day. Oar most striking results have been obtained with 
the larger doses ; a large dose sometimes succeeding ad- 
mirably after the failure of a small one. Before commenc- 
ing treatment we inquire carefully into the menstrual his- 



Periscope. 443 

tory of the patient, and as a rnle give the remedy only for 
the three or fonr days immediately preceding the expected 
period ; but should it fail to produce the desired effect we 
direct the patient to continue steadily taking it, and in 
some cases it has been taken continuously for nearly three 
months. In our experimental observations we have given 
the one drug only and have done nothing in the way of ac- 
cessory treatment. Our most striking results have been 
obtained in young women between the ages of eighteen and 
twanty-five, who from some accidental or trivial cause, 
have ''missed" once or twice after having been regular. 
The administration of one or two grains of permanganate 
of potash in pill three or four times a day for a few days 
before the time of the expected period will bring on the 
flow almost to a certainty. In some instances the periods 
were brought on after the patient had ceased menstruating 
for over a year. In the case of country girls who have 
" seen nothing " for a month or two after coming to town 
the treatment has answered admirably. Often enough pa- 
tients do not consult their doctor until they are "overdue," 
until the time for the expected period has passed by for 
some days. Even then the prompt administration of per- 
manganate will often bring on the flow at once, but should 
it fail to do so the treatment ought to be continued, and 
the patient will probably menstruate normally at the next 
monthly time. Generally our efforts are not crowned with 
success until the medicine has been taken for at least three 
or four days, but in some instances the permanganate acted 
with striking rapidity, the menstrual flow making its ap- 
]Dearance after onh^ two or three doses had been taken. It 
is not necessar}^ to discontinue the treatment on the ap- 
pearance of the menses ; in fact we generally tell the pa- 
tient to continue taking the pills three or four days longer, 
finding that it facilitates the flow. The permanganate often 
succeeds well after the failure of other remedies, such as 
iron, aloes, nux vomica, strychnia, Pulsatilla, nitro-glycer- 
ine, and hot mustard baths. Sometimes, however, it is 
necessary to give it for six weeks, or even longer, before 
the desired result is obtained. In those cases where the 
patient has menstruated only once or twice, and has then 
entirely ceased for some months, our treatment answers 
well ; the menstrual function is re-established, and thence- 
forth proceeds normally at every successive monthly i^eriod. 
In some cases there was no actual amenorrhea, but the flow 
was scanty, lasting perhaps only a single day, or it may be 
only a few hours. Here the administration of the perman- 



444 The Peoria Medical Monthly. 

ganate prolonged the flow, and even in some instances 
when it had ceased, brought it on again. 

It is not only in tlie case of young women that man- 
ganese is so useful, it succeeds almost equally well with 
women between thirty-five and forty, who, as the result of 
many pregnancies and much suckling, have ceased to be 
regular. Here, for example, is a typical case. A married 
woman came to us complaing that she was never regular. 
She had had nine children in as many j^ears, and rarely saw 
any thing more than once between her pregnancies. She 
had been suckling for eight months, and had not been 
poorly for seventeen months — the nine months she had car- 
ried and the eight months she had suckled. She was not 
in the family-way, but said she expected she would be soon 
if she weaned the baby. She did not know when she ought 
to be poorly, and had given up all expectation ol seeing any 
thing. She was ordered to one-grain permanganate of 
potash pills four times a day, and came on poorly a fort- 
night after, the first time for seventeen months. 

We need hardly say that before treating the amenor- 
rhea care should be taken to see that the patient is not 
pregnant, although we are satisfied that the permanganate 
given in the dose we recommend has no power to produce 
abortion, either in the early or late stages of pregnancy. 
We find that manganese fails to induce the flow when the 
amenorrhea is due to advanced phthisis. But in some cases 
of arrested phthisis the treatment was successful, and the 
patient, after a time, under the influence of permanganate, 
menstruated freely and at regular intervals. In several in- 
stances patients informed us that the pills had proved of 
value in curing "whites" of long standing. As a rule the 
permanganate is taken without difliculty, but patients 
much prefer the pills to the solution. The solution is pecu- 
liarly disagreeablo to take, and in some case produces nau- 
sea and even vomiting. Patients frequently complained 
after taking the pills of a heavy and persistent pain over 
the upper part of the sternum, "as if something had stuck 
there and would not go down." This was not due to the 
drug being given in the form of a pill, for the same com- 
plaint was made when the same dose w^as given in solution. 
One patient said the pain was of a burning character, and 
another said it was like heartburn. 

That the eflects we have described are due to the man- 
ganese, and not to the potash in the salt, is shown by the 
fact that manganate of soda and binoxide of manganese are 
equally efficacious in the treatment of amenoridiea. The 
manganate of soda was given in two-grain pills, two four 



Periscope. 445 

"times a clay. It may be thought that the manganese acts 
by improving the condition of the blood, but this is not the 
case. The treatment succeeds equally well in the plethoric 
and in the anemic. Given in cases of chlorosis, the per- 
manganate not infrequently brings on the period without 
in any way improving the anemia. 



Tubercle Bacillus and Plitliisis. 

Dr. T. Henry Green, Physician to Charing Cross Hospital 
and Senior-Assistant Physician to the Hospital for Con- 
sumption and Diseases of the Chest, Brompton, in conclud- 
ing a lecture on the relation of this micro-organism to 
phthisis, observes, with regard to treatment: "'What is the 
practical teaching of Koch's discovery with reference to the 
prevention and cure of phthisis 1 If our pathological con- 
clusions be even only partially true, they clearly indicate, I 
think, the necessity of carefully distinguishing between 
the bacillus and the conditions which favor its influence, 
and of directing oar treatment to both. We must endeav- 
or to prevent the access of the organism, and, if possible, 
to destroy it after it has affected an entrance ; and we 
must also strive to maintain a healthy condition of the pul- 
monary tissues, and thus prevent the occurrence of that 
tendency to apical stagnation which appears to be such an 
important, if not essential, factor in the disease. The lat- 
ter of these indications is, I believe, as important as the 
former : and it is, perhaps, rather in danger of being lost 
sight of in the very natural eagerness with which attention 
is now being directed towards the bacillus. 

" Firstly, then, with regard to the condition of the lung 
which favors the influence of the bacillus. Here it is only 
necessary to remark that, whatever promotes a vigorous 
state of health will, by improving the condition of the 
blood, the nutrition of the vessels, activity of the circula- 
tion, and exercise of the respiratory function, tend to pre- 
vent that stagnation and transudation in the highest por- 
tions of the lungs, the etiological imxDortance of which we 
have so especially insisted upon. The value of treatment 
which has for its object the fulflllment of these indications 
in the prevention of phthisis it is, I believe difficult to 
over-estimate ; and its usefulness is almost equally valua- 
ble wdien the disease is established. I cannot but think 
that, in the meantime, such treatment promises better re- 
sults than any attempts to attack the specific organism. 
Secondly: the tubercle bacillus. The consideration of this 
naturally divides itself under two heads: (a) the prevention 



446 The Peoria Medical Moni'hly. 

of its access, and (b) attempts to destroy it when the dis- 
ease is developed, (a) The prevention of the access of the 
bacillus. The present position of our knowledge appears 
to point to the desirability of adopting measures for the 
disinfection and destruction of the sputa of patients suffer- 
ing phthisis ; and perhaps, also of the alvine secretions, 
when there is any evidence of tuberculous disease of the 
bowel. It also raises the question as to how far it is desir- 
able to allow individuals who are not consumptive, but 
who inherit a phthisical tendency, and especially when 
such individuals are out of health, to intimately associate 
with those who are suffering from the disease. If our path- 
ology continues to move on the same lines, this subject 
may become one requiring the consideration of those who 
manage our hospitals, (b) The destruction of the bacillus 
after the disease is established. Attempts to do this are 
made principally by means of antiseptic inhalations. This 
is the fashionable, though perhaps somewhat misdirected, 
therapeutics of the day. A respirator charged with some 
antiseptic, such as creasote or carbolic acid, is now being 
largely used in the treatment of phthisis. Although I 
should be very sorry to unfairly criticise such treatment, I 
cannot but think that the evidence that its usefulness is in 
any way dependent upon its destruction of the bacilli, or of 
any infective substance which they originate, is wanting. 
It seems to me much more probable that such inhalations, 
when beneficial, are so mainly through the favorable influ- 
ence which they exercise on the mucous membrane and 
secretion ; and when, as is often the case, they are com- 
bined with chloroform, they wall also act as direct seda- 
tives. What we want are cases of early and progressive 
phthisis in which antiseptic treatment alone, without ad- 
juncts, is followed by marked improvement. When it can 
shown, e.g., that the pyrexia of early phthisis is reduced by 
such treatment, we shall have evidence pointing to the in- 
fluence of the germicides upon the bacillus of considerable 
value. We are now making some observations in this 
direction, but, at present, with negative results. Whilst, 
therefore, I do not wish to be understood to discourage the 
treatment of phthisis hj antiseptic inhalations, I think we 
must be careful as to the interpretation w^e put on their re- 
sults. The treatment of phthisis and of other pulmonary 
diseases by means of medicated atmosphere has been 
greatly stimulated by Koch's discoveiy. Such treatment 
has undoubtedly been too much neglected in the past. 
But, in the meantime, T think we have no evidence that we 
ai-e able by such means to influence the tubercle bacillus ; 



Periscope. 447 

although, if Koch's investigations be true, the discovery of 
some agent which, by destroying it, will arrest its injurious 
influence, is obviously the greatest desideratum." — British 
Medical Journal. 



Sulphate of Zinc as a Specific in Scarlet Fever. 

Whilst talking with Dr. C. S. Harris, a retired physi- 
cian of this county some months since, he gave me the fol- 
lowing account of his use of sulphate of zinc in scarlet 
fever : 

He stated that whilst practicing medicine some years 
before, in another part of the State, he encountered an 
epidemic of this disease which was quite fatal ; that he 
had under his charge a patient, a little girl about eight 
years of age who was suftering from so violent an attack of 
this disease that he anticipated unfavorable termination ; 
that he had notified the relatives of his gloomy prognosis ; 
received from them a request that he would call in their 
old family physician from another part of the State who 
chanced to be in the neighborhood. This he gladly did. 
After visiting the patient. Dr. Harris remarked to the con- 
sulting physician "that case is bound to die;" "I see no 
need for it." replies the other. " What," says Dr. Harris, 
" do you know any remedy which will counteract this dis- 
ease ? " "1 do," says the other, "if you will rub nine grains 
of zinc into a fine powder, divide it into powders, give one 
every third hour, and you will find her better to-morrow." 
Dr. Harris acted on this suggestion, but at his next visit 
was surprised at the improvement. The interval between 
the doses was lengthened to four hours, and the numbers 
finally reduced to three a day. Under this treatment the 
child rapidly recovered. Since this time the doctor has 
used this remedy he says, in numerous cases, and always 
with the happiest results. He has no theory as to action 
of the remedy ; but simply knows it cures. In no case he 
states has he seen it produce emesis or other unpleasant 
results. 

On the 13th of April, 1882, 1 was called to see Lula Mc- 
intosh, a little girl four or five years of age, who had been 
taken sick the day before with high fever, headache, stupor 
and pain in the back and limbs. She presented at my first 
visit the following symptoms : From head to foot the most 
distinct and intense scarlatinous eruption presented itself. 
The tongue was heavily coated ; red and enlarged papillae, 
showing through the white coat. The throat was redder 
than natural ; but was not sore — pulse, 160 : temperature^ 



448 The Peoria Medical Monthly. 

104. There was no scarlet fever prevailing ; but some re- 
latives had arrived at the house from Tennessee some ten 
days before and it was thought they had introduced the 
disease. It certainly seemed to me to be scarlet fever in 
spite of the absence of the throat symptoms. I was desir- 
ous of trying Dr. Harris' remedy, but was afraid of the dose. 
1 therefore ordered l-18th of a grain of sulphate of zinc 
rubbed up with sugar to be given every three hours, and 
ordered her thoroughly greased. 

On the 14th I requested Dr. J. B. S. Holmes to see the 
case with me. He also was of the opinion that it was 
scarlet fever. The child had improved very much. The 
eruption had almost entirely disappeared ; the tongue had 
cleansed ; looked like a piece of raw beef. Pulse was 101 ; 
temperature, lOlf. The child felt well : had felt better she 
said after the second dose of medicine. She wanted food 
and wanted to get up. 

On the 15th the child had still further improved — 
pulse, 128; temperature. 100. 

On the 16th, pulse, 120 ; temperature, 98^. 

On the 18th desquamation had commenced, and an 
epithelial coat was being formed on the tongue. The 
bowels had been acted on every day ; no sickness had been 
produced. The medicine was gradually diminished after 
the 16th. 

Scarlet fever is, at least of late years, so rare a disease in 
Georgia, that it maj^ be a long time before I encounter an- 
other case in which to try the remedy. I therefore write 
this article based on a single case in order to request other 
physicians more likely to encounter the disease, to test the 
efficacy of sulphate of zinc in scarlet fever. If it is the spe- 
cific which Dr. Harris claims for it, its value cannot be 
over-estimated. — Nashville Jotitiial of Medicine and Sur- 

r^'V' 

Dialyzed. Iron. 

Dr. Prosser James has lately said, in a summary of the 
position which dialyzed iron is entitled to hold in medicine, 
that the persalts of iron are frequently employed solely on 
account of their astringency, while the protosalts are occa- 
sionally considered as being destitute of this quality. The 
freshly-prepared carbonate is an excellent mild chalybeate, 
but difficult to keep in an unaltered state, so that prefer- 
ence is given to reduced iron. The scale preparations of 
iron are held in repute, both from the extreme facility of 
their use, and their agreeable taste. When these three 
forms of iron are inadmissible, dialyzed iron may be resorted 



Periscope. 449 

to with admirable effect. It is a milder chalybeate than 
the three preceding and does not produce the slightest irri- 
tation. 

A recent analysis of Professor Tichborne of Wyeth's 
preparation ao-rees almost exactly with Graham's state- 
ment, that dialyzed iron contains 98.5 parts of the oxide 
and 1.5 parts of hydrochloric acid. The liquid thns ob- 
tained differs altogether from an ordinary solution of salts 
of iron, by its not given rise to the blood-red color on the 
addition of alkaline snlphocyanide, nor to the blue precip- 
itate with ferrocyanide of potassium. It does not become 
cloudy on boiling, nor when agitated with two parts of 
ether and one part of alcohol is the ether layer colored yel- 
low. It is so sensitive that ordinary spring water will 
cause a precipitate, yet no precipitate is produced by nitric, 
acetic, or muriatic acid. Clraham's solution gelatinized in 
about twenty days, and he regarded it as a solution of col- 
loid ferric hydrate which, he considered, existed both in a 
soluble and insoluble form. It is, however, never free from 
chlorine. Theoretically, therefore, the liquid is a solution 
of a basic oxychloride, but it can never be imitated by dis- 
solving saturated solutions of the hydrate. All these arti- 
ficially-made liquors are astringent, with ferruginous taste 
and acid reaction. 

Respecting the therapeutic value of dialyzed iron, of 
which there has lately been some inclination of doubt. Dr. 
James says there is no question. By the method now fol- 
lowed of counting blood-corpuscles, it is found that the 
taking of dialyzed'iron both increases their number and im- 
proves their condition. Dr. James gives, as an average 
dose, twenty to fifty drops daily, in three doses. Dr. Weir 
Mitchell, of Philadelphia, gives as much as a drachm at a 
time. 

Specimens have appeared in the market which are not 
only innocent of any acquaintance with a dialyzing mem- 
brane, but seem little else than diluted solution of perchlo- 
ride of iron. — From the London Chemist and Druggist. 



Antiseptics in Phthisis. 

Dr. William Porter. Physician to Throat and Lung De- 
partment, St. Luke's Hospital. St. Louis, thus summarizes : 

Proven, it seems to me. are these two propositions : 

1st. Phthisis is a specific disease from a specific cause. 

2d. Phthisis may be produced by absorption of tuber- 
culous matter in contact with the mucous membrane of 
the air passages or intestinal tract. 



450 The Peoria Medical Monthly. 

There is also evidence that the energy of this tubercu- 
lous matter is due to germ development and progression. 

Hence the value of antiseptic influence in the treat- 
ment of phthisis, not only in the later stages during pus 
protection and obstruction, but also in the earlier process of 
infection. 

One great demand is for that, which by local and inter- 
nal use, may meet and destroy the septic agencies of dis- 
ease. Such a remedy must be effective, unirritating and 
non-poisonous, susceptible of ready dilution and easy ab- 
sorption, and withal inoffensive in odor and taste. 

Carbolic acid and iodoform do not fully meet these re- 
quirements, and less harmful yet no less potent means of 
antagonizing contagion and putrefaction are finding favor. 
The compound known as Listerine has, for nearly two 
years, served me better than any other remedy of its class, 
and, in the treatment of phthisis, has almost supplanted in 
my practice ail other antiseptics. In treatment of diseases 
of the upper air passages it is pleasant and does not ini- 
tate ; in the fermentative dyspepsia so often accompanying 
phthisis it is safe and efficient. 

It is the most powerful non-toxic antiseptic I have yet 
found. — Lancet and Clinic. 



Extension in Sciatica. 

Dr. M. Shoemaker has quite an interesting article in a 
recent number of the Medical Record, on the treatment of 
sciatica by extension with the weight and pulley. 

A number of cases are mentioned in which the proced- 
ure gave prompt relief, and was, in the course of time, per- 
manently curative. The method of procedure is to apply 
the weight and allow it to remain until the limb is thor- 
oughly tired and the pain relieved. As soon as this has 
been accomiDlished, traction is ceased. The procedure is 
renewed as soon as the pain returns. 



Scared to Death. 

A negro died in the Louisville City Hospital recently 
from superstitious terror, as the medical attendants believe. 
To be sure, his physical condition was not good ; but he 
could have been cured, in their opinion, except for the con- 
viction that he was about to die. He did not tell in what 
way his fate was revealed to him, but he was not to be 
convinced that it could be averted. After four days in the 
hospital, during which he was able to walk around, he an- 
nounced that his time had come, and, lying down upon the 
floor, died almost instantly. " Scared to death" is the ver- 
dict of the doctors. — Chicago Medical Record. 



Periscope. 451 

The American vs. the European Profession. 

In reading the foreign journals one cannot but be 
struck by the frequency with which he encounters reports 
of remarkal^le operations and clinical histories of peculiar 
phases of disease, as compared with similar reports in our 
own medical periodicals. 

We have often reflected on this, and wondered at the 
cause. 

The body of an American is formed on the same prin- 
ciples and subject to the same pathological and physiolo- 
gical laws as that of the European ; it is but reasonable, 
then, to suppose that it would be affected by the same in- 
jurious agencies in the same morbid manner. 

We have in this country a large number of persons, 
and a great army of physicians ; the same diseased condi- 
tions must obtain, and the necessity for similar surgical 
procedures must exist. 

Why, then, is it that in English journals we read of 
nephrotomy and nephrectomy, of gastrotomy and oesopha- 
gotomy, of removal of the larynx, and the like ? 

Why do we find reported cases of "acute traumatic 
malignancy ;" wdiy do we read lectures on " the pre-cancer- 
ous stage of cancer," and innumerable other odd and sin- 
gular phases of diseased condition, evidencing, as they do, 
acute observation of facts, and accurate generalization 
from them ? 

Our profession, as a body, will compare favorably with 
that of any nation of the world. We have original think- 
ers, accurate observers, and broad generalizers. We are 
not any more conservative than our brethren of other 
countries. 

Why, then, is it that we do not read in our journals 
similar cases to those reported in the medical press of Eng- 
land, for instance ? 

We imagine that the explanation is to be found in the 
fact that the physicians of this country do not thoroughly 
realize the importance of the medical press, and therefore 
do not cultivate it as they should. 

This is one reason ; this is why we do not read more 
practical clinical reports of unusual cases ; and the unfor- 
tunate habit of looking to older countries for innovations 
in practice makes us hesitate to try new operations until 
their utility has been demonstrated for us. 

There are some American physicians who write too 
much ; but the great majority do not write enough. 

Medical journals are the vehicles of interchange of 
thought and experience between the members of the pro- 



452 The Peopja Medical Monthly. 

fession : and a plij^sician should make it a rule always to 
report every case that may occur in his practice in which- 
■day phenomt-nainay present themselves that he does not 
hud recorded in his text-books. 

But he should be short and explicit. Many an other- 
wise good communication has been rendered worthless hj 
being too loug-irinded , the valuable points have been 
bmothered in a lot of trash. 

When a man feels sure that he has something new to 



ji 



report, he should reflect how he can say vvhat he has to say 
in as few words as possible. He will thus prepare an ar- 
ticle that will be readable as well as valuable, and will not 
encroach unuecessarih^ on the limited space of a good 
journal. 

Physicians should likewise cultivate the habit of inde- 
pendent thought and reasoning in their practice ; and 
should not, as so many do, practice strictly according to 
the rules laid down in the books. 

Short, practical communications are always of value, 
and tiie profession of our country should make it a lule to 
prepare them frequently. — Med. and Sunj. licpoiiey. 



The Wisdom Teeth aud Deafness. 

liol^ert T. Cooper. M. D., in the Dublin Journal of Medi- 
cal ^SVvV'y/ms, reports several cases where he believes that the 
deafness owed its origin in each patient to a tardy or other- 
wise abnormal eru])tion of the wisdom teetlh That the 
teeth are often the u'asuspe<:'ted cause of deafness, he in- 
fers, hrst. " from the intimate sympathy existing between 
the teeth and the ear>. and the consequent very obvious 
prejudicial effect of infantile dentition upon these organs. 
And, secondly, from observing the number of cases of deaf- 
ness met with that date their initiation from the- period of 
life at which these teeth appear." — Gaillard's Med. Jour. 
June. 



Cystitis. 

Dr. Wm. H. Pancoast resently recommended at one of 
his clinics at the Jefferson Medical College the following 
mixture for an acute case of cystitis : 

5 Fl. ext. tiiticum lepens., 3 ounces. 

Syr. orgeat, 2 ounce.s. 

M. S. Two teaspoonfuls in water five or .six times 
daily. — Medieal Bulletin. 



Therapeutic Notes. 



453 



iltcvapcutir ^cU^. 



VAGI>-ITIS. 

5 Acid tannic, 50 parts. 

Amylii, 150 parts. 

Ung. petrolei, 150 parts. 

M. This ointment is placed in a 
sort of speculum, so arranged that the 
ointment can be forced out as the in- 
strument is withdrawn from the va- 
gina. If the vulva opening be large, a 
small tampsen of cotton is used. Gen- 
erally from lialf an ounce to twelve 
drachms of the unguent is suificient at 
oue application, and it need not lie re- 
peated for seven or eight days. 

CHILLS. 

IJ Quinise sulphate. 30 grains. 

Cichonidiaf sulph., 30 grains. 
Acid .sulph.. 10 minims 

Lig potas. arsen., 1 drachm. 

Ex. niicis vom. 11., 10 minims. 

Aqua? qs. ad., 4 ounces. 

M. Tablespoonful every four hours 
■when tlie fever is off. 

— Phiirjjt. r.Jid ^'/icjii. 

v,'n'_)OPixo corGrH. 

5 Pota.'^sii bromidi. ^o drachm. 

Sodii bromidi, 1 drachm. 

Ammon. l)romidi, i< drachm. 

Syr. chloral. i.j' ounce. 

Aqure, 2 ounces. 

M. Sig. Desertspoonful of tlie mix- 
ture in a glass of milk to which the 
yolk of an egg has been added, morn- 
ing and evenin'Z. — Med. -Sum. 

TO CORRECT TtlE ODOR OF THE LOCHIA 
AFTER CHILD-BIRTH. 

Ff Acid carbol. glacial, 1 ounce. 

Glyceriniic, 1 ounce. 

Aq. purse, 8 ounces. 

Sig. Tablespoonful in eight ounces 
of water twice a day as a vaginal in- 
jection. — Med. Sion. 

TO HARDEX THE NIPPLE. 

5 Acid tannic, 4 drachms. 

Glycerine, 1 drachm. 

Aqua? ad., 2 drachms. 

Sig. Apply. This actually tans the 
nipple. — Southern Med. Record. 

TO DISariSE TASTE OF QnXES'E. 

5 Fl. ex. yerba santa, 4 parts. 

Water, 8 parts. 

Pov.dered pumice, 1 part. 

Grnnulated sugar, 14 parts. 

Mix tbe fluid extract with the water, 

evaporate to seven parts, shake with 

the pumice, allov.- to stand, decant, add 



sufficient water to preserve the meas- 
ure, then with heat dissolve the sugar. 
— Indi'i. lid. Fharma cist. 

CHROXIC IKTERMITTESTS. 

After arresting the paroxysms, follow 
up with one ot^the following, to be 
taken at a month : 

Vf Quinine sulph, 1 drachm. 

Sol. arsenit. potass, 1 drachm. 

Acid sidph. oil. 2 ounces. 

Syr. zjngieris, 2 ounces. 

M. ■ Sig. Teaspoouful three times a 

day after meals. 

Or tliis may be u.sed : 
R' Acid arseniose, 4 grains. 

Strychuiae sulph, 2 grains. 

Cinchonidise sulph, 1% drachms. 
Ferri subih essic, l^l drachms. 
Aloe. soc. ext., 1 scruple. 

M. Ft. pil Xo. 90. Sig. One pill 
three times a day afjer meals. — Sash- 
c'lle Med. Jour. 



TASTELESS QUININE. 



R 



2 scruples. 

2 scruples. 

3 grains. 

2 ounces. 



M. 



Quinise sulph, 

Pulv. acaci:p. 

Acid tannic. 

Syr. simplicis. 

Sig. Give half to one teaspoon- 
ful every iwo hours to children, accor- 
ding to age. — J/j'/J. 

Note. — As there would be over one 
grain of quinine to each dose of the 
a.bove, the whole would be a larger 
quantity than necessary to break up 
the paroxysm. A better direction 
woukl be to give half of the above at 
the first and lialf on the third day. — 
Ed.] 

hair wash. 

R Potassii iodide. } 
Pulv. sodii biborat ' 
Aquae ammon, 
Tr. lytta? res, 
01. rosniarini, 
01. myristicase, 
Aq. colognieusis, 
01. luacidis, 
Aqufo, 



}-aa 11-^ ounces, 

J 

2 drachms. 

2 ounces. 
4 pints. 
134 ounces. 
8 pints. M 
-Med. BuVetin. 



toothache paste. 

Iodoform. 00 grains. 

Kaolin. 00 grains. 

Carbolic acid, 8 grains. 

01. peppermint, 10 drops. 

Glycerine, q. s. M 

Apply to the exposed nerves. 



TIZE! 



Peoria Medical Month]. y. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-Jeflferson Street, .... PEORIA. ILL 

***The Editor is not responsible for the statements or opinions of contributors. 

***.Short original articles are invited from any reader, whether a subscjiber or not. 

***If extra copies are desired by a contributor, the number must be specified when 
the article is sent in to the Editor. 

*** .\11 exchanges, books for review, and communications must be addressed to th 
Editor and Publisher. 

***The publication day of this journal is on or about the 15th of each month 

**,i;To subscribers! A. pencil mark at this place indicates that the time of your .sub- 
scription has expired, and that a prompt renewal is urgently requested. 

Samples of Missouri Quackery- 

We cull the following gems from Dr. King's address on 
Quacks and Quackery in Missouri : 

An old practitioner said that '' Dover's powder was a 
favorite remedy w^ith him as it would produce a gentle di- 
apporefus and had a soothin' effect on the mucus mem- 
brane of the brain." Explaining vicarious menstruation, 
the same doctor said, "the blood is stopped in the woml) and 
forced through the fallopian tubes into the lungs." 

"Mr. poste master pleas scend my male to the turn 
back poste Ofice af you pleas sir Any is in the ofice for rue 
Dr. J. R. G." 

A doctor said that, " as soon as the lochia ceased to 
flow through the mouth and were established through the 
vagina, the convulsions would cease." She had bitten her 
tongue. 

A quack went for a regular physician to operate for 
strangulated hernia, which he said he had tried for t\\ o 
days to reduce by taxis. But arrangements were not com- 
pleted before a red-headed boy rode up to the oflBce and 
said, " You doctors needn't come ; Bill only had a bile and 
it's busted." 

A quack rubbed a solution of plumbi acetatis on a wo- 
man's abdomen, and shortly afteward pulled up the cloth- 



Editorial Department. 455 

ing and showing the hiishand a discharge from the vagina 
said, " There, now ! don't you see ? The medicine is ab- 
sorbed already." 

On being asked as to the health of his neighborhood 
one said, '' 0. sickness is debating/" On being further asked 
how he got along so w^ell with the prevailing fevers, he 
said, "Well. I'll tell you, but I won't tell them d — d quacks 
out in the country. I take some soda, and put a little 
w^ater in one glass, some acid in another ; I then pour them, 
together, and let the patient drink it while it is vesicating." 

A female doctor was called to see a lady who was suf- 
fering from hemorrhage of the kidneys. The doctress sta- 
ted that she "knew all about it — her father had the same 
disease — hemorrhage of the prostate gland." 

One quack said " he gave the patient a little turpen- 
tine as her bowels were a little gastric." 

Another told a gentleman who had synovitis of the 
knee-joint, that "there was a rheumatic worm in the joint 
eating up the asphaltum.'' 

A root doctor has but three medicines, all made from 
the same root. He calls them respectively "Hibobalorum, 
Lobobahirum, and Hi-lo-bustem." One is a cathartic, an- 
other an emetic, another, last, " a rank pizen" which will 
bust his patients open. He makes the first by peeling the 
bark downward, the second by peeling it upward, and the 
last by peeling it around, 

' Many pages of Dr. King's address were filled with sim- 
ilar " uncut jems." They are fuijny — many of them, and 
serve to excite a laugh, but to an honorable practitioner 
they cause a blush. 

We quote a paragraph or two from his paper : 

" The condition of things shown is enough to sicken 
any man who has any regard for the dignity, standing and 
honor of our profession ; and is sufficient to alarm and ap- 
pall any person, not a doctor, who is capable of appre- 
ciating the danger in which the community is placed, by 
reason of the presence ol many illiterate and incompetent 
men in their midst assuming to represent our noble profes- 
sion and to take charge of the issues of life and death. 



456 The Peoria Medical Monthly. 

'^ The presence of these ignorant pretenders and swind- 
ling rascals is a standing cause of shame and annoyance to 
every worthy, honest and competent physician ; for say 
what we will the people— the great majority of whom do 
not seem capable of distinguishing between the true and 
false in our profession — ivill class us with these creatures 
and iiiJ] call upon and beg and importune us to meet them 
in consultation in cases threatening life, and our refusal to 
do so often puts us at a disadvantage before a community 
which has more heart than brains." 

The Medical Practice Act in this State (Illinois) has 
done much to free us of these vampires, but a few loop- 
holes were left through which a good many incompetent 
persons were given the right to trifle with the lives of the 
people. The clause permitting those who had practiced 
for ten years prior to the passage of this act, to continue 
without examination or hindrance was the weakest part ot 
the whole. 

We have latelj^ seen a certificate returned to the Coun- 
ty Clerk of St. Clair County by one of these '' ten year " 
men. 

The deceased's age w^as given as seventeen, while a lit- 
tle below it was stated that he had been a resident of this 
state twenty-one years. The cause of death was rather un- 
ique: ''first disease Gravel, stop the water,'' complications, 
"Imergy (?) of the blood of the nose and mouth; Pluru 
Pomonie." 

We have frequently seen returns made in which the 
cause of death has been variously given as " Earysipelas,'^ 
" Arysiplas," "Malerea," Parallases," " Numonia," "Amo- 
onia," '• Arasipolas." etc., etc. 

This may not be evidence of such open quackery as 
exists in Missouri, but it is evidence of the most unadulter- 
ated ignorance and almost an equal blot upon our fair name 
as physicians. 

Mississippi has the best law" regulating the practice of 
medicine of any that we have yet seen : the best because 
it is the strictest. A diploma is not sufficient evidence of 
ability, nor yet twenty or fifty years of practice, but every 



Editorial Departmext. 457 

man must pass an examination in the fundamental 
branches : anatomy, physiology, chemistiy. materia medica, 
obstetrics, surgery and perhaps one or two more. This ex- 
amination he rmid pass : after this he may practice anj^ 
■•pathy'" he pleases. 



Rusli College eoiiiineiiceaieiit. 

The fortieth annual commencement exercises were 
held in the Central Music Hall, Chicago, Tuesday, Febru- 
ary 20. 1SS3. The Faculty appeared for the first time 
clothed in the robes peculiar to their office, such as are 
worn by professors in Europe, and to some extent in Amer- 
ica. 

After the degree was conferred upon a class of 17S, Dr. 
<iunn delivered the Doctorate Address. It was almost en- 
tirely ethical in character, and as we have seen only a 
newspaper report we cannot give a fair synopsis of it. It 
will soon lie printed The annual banquet given by the 
Faculty to Paish alumni w^as held the same evening at the 
Clrand Pacific Hotel, and was attended by about 400 guests. 
Xeedless to say a good time was had, and everybody was 
satisfied. 

Dr. Jno. Guerin, Chicago, was elected President of the 
Alumni Association ; Dr. T. F. Russell, Oshkosh. First, and 
J. W. Fisher. Milwaukee, Second Vice President. Secretary 
and Treasurer. F. A. Emmons, Chicago. Executive Com- 
nittee : W. J. Maynard, E. P. Davis, A. D. Bevan. Prize 
Essay Committee : C. I. Fenn. J. S. Knox. 



All Ofter. 

It is a matter of great inconvenience to the publisher 
to have renewals fall due at eveiy month of the year. It 
would be much more satisfactory to have all begin with 
the volume in Ma)\ This, however, is scarceh^ practicable 
in all instances, but to approach as nearly as possible to it, 
we have determined to make our subscribers this proposi- 
tion : All past due renewals if paid at once will be credited 
up to May. A few^ in this w^ay will receive part of a year 



458 The Peoria Medical Monthly. 

gratis, but the convenience to us will more than counter- 
balance the loss. 

Take notice then : Every one who has received notice 
that his renew^al is due at any time during the past year, 
will, if he pays at once, get credit from May. Verl). sap. sat. 

Aalso all subscriptions received during March and 
Ayril will be credited from May. This will give two num- 
bers or nearly 100 pages extra. 



Notes and Comiiieiits. 

The latest remedy for the vomiting of pregnancy is 
pop corn. 

Women have a college of pharmacy all to themselves 
in Louisville. 

Professor Helmholz has been made a noble by the Ger- 
man Emperor. 

For cruelty to his family a Cincinnati physician has 
been sent to the workhouse for thirty days. 

For many of our news items this month we are in- 
debted to the Detroit Lancet and its able editor. 

The death rate oi last year for New York City was 29 
per 1,000. There were 10,000 less births than deaths. 

At its late commencement the medical department of 
the California State University graduated fifteen persons. 

In New York the Sunday hospital collections this year 
were but |20,000. against an average of $37,000 for the 
three preceding years. 

Of eleven physicians who died in Texas last year, three 
died by accident, three were shot, and five committed sui- 
cide. 

The ln*ain of Gambetta was found to be below the av- 

ei'age weight, only thirty-six ounces — a microcephalic 
brain. 

Towns neai- London have on an average 50 per cent, 
more sunny days than the great city. Such a dark pall 
is London smoke. 



Editorial Department. 459 

At the College of Physicians and Surgeons of Balti- 
more, five students have had small-pox and two have died. 

Gaillard's Medical MoHfhlt/ states that there are 2.000 
cases of small-pox in Baltimore, of which onl}^ SOO have 
been reported by the board of health. 

At the post moiiem examination of the late Dr. George 
M. Beard it was found that his death was due to an embolic 
pneumonia originating in an abcess of the upper maxilla. 

The board of commissioners of New York have dis- 
missed Dr. Carnochan from the post of consulting surgeon 
to Ward's Island, and appointed Dr. H. H. Sands in his 
stead. 

In the ruins of Pompeii has been lately discovered a 
quadrivalve speculum, exquisitely proportioned, with a 
movement unsurpassed by the most perfected of modern 
instruments. 

On page 388 of February issue of this journal, seventh 
line from the top. read " a larger zone" instead of ** a layer 
zone ; also, on page 401, same issue, third line from the 
bottom, read '"present "' instead of *' pleasant." 

There has been a great scramble for a parish appoint- 
ment in the slums of Edinburgh, worth $300 a year. A 
sample of the fierce struggle of medical men for existence. 
Will the fittest survive under such conditions ? 

At Sheffield. England, thirty women recently delivered 
are known to have been infected with syphilis by the same 
midwife. Nine husbands have also been infected, and some 
of the infants. The midwife has been prosecuted. 

The editor of the Aliettisf and Np/fro/of/isf says that he 
needs no register of medical men, because all eminent men 
who do not take his journal are recorded as approving of 
the several proprietary medicines presented to his notice. 

Dr. Polk recently removed a displaced kidney : the pa- 
tient lived eleven days, when it was found that she had but 
one kidney, the one removed. The case was of interest as 
showing how long a person can live without any kidnej' 
tissue. 



460 The Peoria Medical Monthly. 

A recent decision holds tliat if a surgeon recovers his 
fee in a suit for the value of his services, no subsequent 
snit can l;)e brought for malpractice, this being settled by 
the results of suit for services. 

If a person knowingly coniinunicates a contagious dis- 
ease to another and death results the crime is that of man- 
slaughter : such is the cominon law. Most persons escape 
because of the expense and troulile of bringing about con- 
viction. 

It ma}^ interest those urging the compulsory notifica- 
tion of infectious diseases to know that in Edinburgh "after 
several years of compulsory notification the death-rate of 
the leading epidemic diseases is higher than it was previ- 
ously." — Brit. Med. Join: 

At (iermantown. Pa., a lady w^as sent to the pesthouse 
for small-pox. It turned out that she simply had measles, 
but at the pesthouse she took varioloid. Five similar cases 
are reported in Baltimore during one week. Rather tough 
on those having measles. 

The Commissioners of Cook County Hospital have a 
sure remedy for settling anj^ disagreement in their med- 
ical staff — the entire staff is at once bounced and a new one 
appointed. Thus within two 3^ears they have had three 
different medical boards. 

Two Philadelphia doctors have been charged in court 
with a conspiracy to ol^tain from a helpless and aged in- 
valid a conveyance of all her property to themselves for 
no other consideration than medical services rendered by 
one of the precious pair. 

Verchojansk in Siberia is said to be the coldest inhab- 
ited town in the world. In 1S82, during January, the ther- 
mometer showed a mean temperature of -43 deg. F., during 
Februaiy -56 deg. F., during March. -37 deg. F. Once the 
thermometer was -81.4 deg. F. 

An exchange says that by actual count "there passed 
a certain point on an ordinary day 105 men. boys and a 
mule : 100 of these were engaged in smoking : five of them 
and the mule w^ere not. Clearly the mule was on the ex- 
clusive aristocrat side of the question." 



Editorial Department. 4(31 

Dr. T. Gillard Thomas is reported as saying : "I believe 
that I represent the feeling of th^ majority of our best con- 
servative men in saving that 1 consider the breaking down 
of the barriers, as was done last year, as disastrous in its 
effects and very much to be regretted." 

Recent extended researches by Berlin, of Stuttgart, 
Germany, show there should be a change in our present 
method of teaching writing. We should place the copy- 
JDOok in an oblique position directly in front of the child, 
instead of to his right and parallel with the edge of the 
desk. 

The recent register of German physicians states that 
there are 17.623 regular practicing ph^'sicians in the Em- 
pire. The proportion in Berlin is one phj^sician to 1.071 
people : in the country one physician to 2.606 people. There 
are 153 medical publications, aside from 95 periodicals from 
medical societies. 

We hope our Illinois friends will not forget the fact 
that the next session of the State Medical Society will be 
held at Peoria. May 15. 16 and 17. Make your preparations 
in time to be on hand, not only to profit by the large meet- 
ing which will be held, but also to see the thriving city, 
now second only to Chicago, and improving at a wonder- 
fully rapid rate. 

In Scotland the medical man is paid " sixty cents "" for 
each case of infectious disease reported to the health au- 
thorities. The rights of the doctor are in this regard fully 
recognized by the government. The penalty for failing to 
notify is $10. In Detroit the doctor gets nothing for re- 
porting, and is threatened with a fine of $500 if he does not 
report. Which is the free country, the country of respected 
individual rights ? 

The first number of Honip Hecdfli. our new sanitary and 
hygienic publication will be out promptly April 1st. Please 
bear in mind that although the regular price is S2 a j^ear, 
subscribers to The Peoria Medical Monthly will get it for 
$1 a year in advance. We believe th^iiHome Health will be 
of great service to every physician, and that they will not 
be slow to appreciate it. 



462 The Peoria Medical Monthly. 

Receipts for February. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in tliis place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify us by card : 

WiscoNfJiN — Drs. Christian Liude, F. C. Moulding. R. L. Teljanf 
Tlios. H. Helm, O. H. Martin, E. E. Moore, C. H. Koetel, H. S. Johu- 
son, C. H. Frost, C. W. Stoeltiug, J. E. Marsh, B. O. & J. C. Reynold.^. 

Kansas— Drs. W. T. Wright, M. Park, J. M. Wright. 

Iowa — Drs. Thos. Garth, C. S. Stroud, R. Stephenson, Jr., D. Mc- 
Caughan, Joshua Richardson, H. Lindner, J. P. Von Stein. 

Nebraska — Drs. A. B. Anderson, L. D. Denney. 

Tennessee — Dr. B. D. Alexander. 

Alabama — Dr. J. L. Faut. 

Minnesota — Dr. Wm. Eison. 

Kentucky — Drs. W. A. Ligon, R. C. Mayes. 

Wyoming Ter.— Dr. T. E. Webb. 

Illinois— Dr. T. F. Roberts (2 years"), J. S. Bell C2 years), Samuel 
Kelley, Charles H. Carter, H. Nance, J. J. Thoraetz, J. F. Todd, A. C. 
Williams, J. L. Kitchen, E. E. Welborn, Geo. Willis, G. W. Dunlap, 
W. Wilson, O. F. Taylor, Geo. Schloetzer, S. S. Clayberg, R. A. Haw- 
thorne, Wm. Dillon, A. Hess, E. Wenger, G. F. English, Edwin T. 
Black. 



Some Things That May Interest You. 

A fountain pen that always writes and never "leaks," that makes a fair, 
plain line, and never blackens the lingers, and that, once filled, can be used for 
days without chanire, avoiding all the bother and interruption of reaching over 
to the inkstand for a fresh dip every two minutes, that can be carried in the 
pocket, and is as handy for use and as neat a.s a lead pencil, and that writes on 
any paper however thin or soft ; such a pen is worth having. And such a pen 
is the " Livermore Stylographic Pen." This we know from personal use. — 
Editor Chicago Advance. 

This pen has been greatly improved and the price reduced to $2, which is 
very cheap. Louis E. Dunbar, 390 Washington street, Boston, is the agent and 
will send the pen and a six month's supply of ink on receipt of the price, 

Celerina is a combination of drugs which meets all the requirements of a 
first-class prescription: it is efficient, agreeable and safe. I have used it in two 
cases of neurasthenia, with highly satisfactory results, and shall give it still far- 
ther trial. " * H. A. Cottell, M. D., 
Demonstrator of Anatomy, Microscopy, [and Medical Chemistry, University of 
Louisville, Medical Department. 

I have used Celerina in mv practice, and find it to be an excellent nerve 
tonic. ' C. W. Null, M. D., 

Professor of Physiology in Louisville Medical College, and .Jefferson School of 
Medicine. 



The Peoria 
MEDICAL MONTHLY. 



Vol. III. APRIL, 1883. No. 12. 



(Driginal (gommuttiationg. 



Art. I. — The riiiiical Uses of the 31icroscope. By Dr. Romaine J. 
CuRTiss, Joliet, 111. 

The use of the microscope iu medicine has come to be 
very nearly as indispensable as is the use of the telescojie 
in the science of astronomy. Of course, not every doctor's 
office contains a microscope as yet. though every observa- 
tory holds a telescope : but the science of medicine to-day 
depends to a very great extent upon the facts which have 
been revealed by the microscope. 

Before the invention of the telescope the stars \Yere 
grouped into constellations alter imaginary likenesses in 
form to the heroes of mythology — the men and women 
who distinguished themselves in love and war, and right- 
eousness, and lust, and virtue, and wickedness. There was 
also quite a science relating to the stars. The Egyptians 
had an astronomy, and there were, throughout the world, 
people who made their living by the arts of divination or 
astrology. The Ptolemaic astrononi}^ put the earth in the 
center of the solar system, and, in fact, the earth and the 
man on it were believed to be the very center of the 
universe. The vain lord of creation had an idea that he 
was made in the image of his Maker, and was the object 
for whose benefit the universe w^as built. 



464 The Peoria Medical Monthly. 

The use of the microscope is not the least among the 
methods by which people have learned that if they are 
made in the image of their Maker, they are also made in 
the image of other animal forms, and even that all their 
tissues, in their ultimate structure, are like the structures 
and the elements of structure, of all other animal creations. 

These two aids to human vision — the telescope and 
microscope — have probably had as much to do with mental 
development as any other known factors. The scope of 
human vision is very limited. The objects of the universe 
which are too far away to be seen to any advantage in 
relation to their structure, and the objects of the earth 
which are too small to l^e seen, probably far exceed the 
number of celestial and earthly objects that can be seen 
by the unaided eye. 

To give special illustrations, we will say that the eye 
will perceive, unaided, lines which may be ruled on glass 
that are, perhaps, 300 to the inch. The average is prob- 
ably not over 200 lines to the inch. Now\ outside of this 
limit are found most of the histological structures, and 
countless numbers of species of living things. The 
inspired writer s injunction to the human sinner: "know 
thyself," could never be even approximated without a 
microscope. No histological structures would ever have 
been found out, and the pathological structures and the 
parasites of diseases would never have been known. 

The telescope, probably, did away with astrology and 
the Ptolemaic astronomy, and the microscope has cut the 
last thread which bound us to the belief in the super- 
natural origin of epidemics. The sky-gazers of the middle 
ages sought for a solution of the cause of pestilence by 
looking upwards. They watched the sky until they began 
to see things — they saw rivers of blood, and armies fighting 
in the air, which they believed were heralds of the sweat- 
ing sickness, the plague, and the black death ; but the 
■man of science, looking through his microscope, has found 
bacillus anthrax, bacillus tuberculosis, and the germ of 
«mall-pox, and typhoid, and septicaemia ; he has found 
trichinae, ecchinnococci and cysticerci, and expects to find 



Original Communications. 465 

the true nature of all contagion and infection, and their 
prevention. 

In this manner the microscope has contributed to bring 
the mind out of superstition and old habits of nonscien- 
tific thought, by finding natural causes to put in the place 
of supernatural guesses. The methods which reveal the 
nature of a man's structure, and the causes ot his sickness 
and death, do more than all other things toward the 
development of the human mind. The microscope gives 
us the knowledge of how to prevent disease, and by this 
means to secure a long life, and we all know that long life 
is a necessity, if the product of human life is to be mental 
development, and happiness, and riches and civilization. 

Without doubt the field of the microscope, which is of 
the greatest practical value, is the clinical field, in special, 
and those revelatiotis which relate to human structure and 
phj^siology and to causes of disease in general. Studies in 
other fields are useful, for the reason that general science 
is thereby advanced, and general laws are thereby formu- 
lated, which help to make up the grand sum of knowledge 
which includes the origin, the structure, nature, and the 
destiny of the human being, and the causes which bring 
and have brought these things about. 

During the last few years the microscope has become 
an instrument of great importance in medical teaching 
This was not so a few years ago. The writer attended two 
different medical colleges and graduated in '"64," and 
during his term of filling the three years requirement of 
medical study for a diploma, he never saw a microscope in 
the neighborhood of a medical college or anywhere else. 
Now nearly every department, or chair, in a medical col- 
lege teaches his special science by aid of the microscope. 
The anatomist shows the histological structures, and the 
physiologist the structures of fluids and animal constitu- 
ents, and proximate principles, and the structure of excre- 
tions, and secretions by aid of the microscope. In short, 
the microscope is equally indispensible, and useful, and 
equally utilized in the sciences of pathology, and hygiene, 
and the line of diseases. 



466 The Peoria Medical Monthly. 

In the daily practice of the physician, as might be 
expected, the microscope is one of the instruments of 
accuracy in diagnosis. In fact, it is becoming an indispen- 
sible necessity. As we shall see, the differential diagnosis 
of many medical and surgical lesions depends in many 
cases altogether upon the microscope, and in many others 
this instrument affords the best method of accurate and 
rapid diagnosis. Of late years the manufacture of micro- 
scopes ,, has increased in great ratio, which sufficiently 
proves the fact of the uses of this instrument. Most of 
the microscopes made are sold to doctors, which shows 
where the field of greater usefulness of the instrument is. 
Id fact, the medical graduate, at present, cannot consider 
his professional outfit coiiiplete without a microscope. 

It may be briefly stated that microscopes are greatly 
improved at present over those of a few years ago, and it 
is also proper to say that the instruments made in this 
country are better than those of foreign make, perhaps in 
every respect. The power of the objective lens was greatly 
increased by Spencer, an American, who, in fact, succeeded 
in making objectives having resolving powers which 
exceeded the supposed limit of possibility. Since Spen- 
cer's time the microscope greatly increased its usefulness 
in the sciences, and in clinical uses, and has made itself 
the indispensible instrument that it now is. 

As every doctor now needs a microscope, and most of 
them want one, and many of them have not yet obtained 
one, perhaps a few hints of practical nature on microscope 
construction and power may be acceptable. Every man, 
before he buys a microscope, must know what the instru- 
ment can do, and why it can do it. The fact is that many 
microscopes ; stand, lenses, and all, may be sold at a very 
high price, and not be very useful instruments, and, at the 
present time, very useful instruments are sold at very 
reasonable prices. In buying a microscope, the stand is 
of course, the first factor to consider. Stands are made of 
as various patterns, perhaps, as vaginal pessaries, and 
many of them are as equally useless and uncalled for. 
Many of the old incumbrances of mechanical stages, etc., 



Original Communications. 467 

are no longer used, and were never of any use. At the 
present time microscopists themselves are wrangling over 
the most desirable weight and size of a microscope stand. 
It is very evident that different men differ in the size and 
weight of their opinions about the most desirable size and 
weight of a stand, and that different men like different 
sizes and weights. 

The various American makers build stands of different 
weight and size for different people and purposes, and all 
of these stands, it may be said, admit of the use of the 
best objectives, and other accessories of the microscope. 
If other things are equal, the owner of a microscope will, 
as a general thing, be better satisfied with a stand of good 
size and with weight enough to resist most of the modes 
of motion which constanly pervade the air and ground, 
and houses and furniture of rooms. 

A stand which will admit of the use of any micro- 
scopic accessory, and of good weight and size, can be 
bought for from $25 to $75, and the best that can be made, 
even if all made of brass and in the best manner, and 
having all the qualities which are necessary to go with 
objectives of the highest power, and which can be used for 
any purpose where a microscope is useful, and which are 
handsome enough, and practical enough, and scientific 
enough, need not cost over $160. 

The next article, which it*s of greatest importance to 
know something about before owning, is the objective, and 
to understand this subject in its outlines, we must review, 
briefly, the nature of the things to be seen by the objec- 
tive, and the powers which the objective must have in 
order to make these objects visible. 

Objects which are visible to the eye present to the 
mind the image of the object as a whole, and more or less 
of the structural elements or factors of the object. We 
see many objects as a whole every day, the small parts of 
which, or the anatomical elements or factors of which, we 
cannot see, because they do not come within the angle of 
vision of the eye. We can see the images of small animals 
perhaps, whose ears and eyes, and perhaps other members 
are not visible. 



468 The Peoria Medical Monthly. 

Now, the same laws, of course, hold good in micro- 
scopic objects. An object, as a whole, may be too small to 
be seen by the eye — ^for instance, a diatom, or blood 
globule, but a lens which amplifies the object five or fifty 
diameters, will enlarge the apparent size of the object, by 
its amplifying power, and will make visible more or less of 
its anatomical or structural factors, by reason of its angu- 
lar aperture, as well as its focal distance, or refractive 
power. 

There are two factors then in the power of objectives 
which aid vision, and in selecting an objective, both of 
these factors must be considered. The distinction to be 
borne in mind is that the focal distance has relations of 
particular character to amplification of the general image, 
and the angular aperture has more special relations to 
the resolution of the structural elements of objects which 
are looked at through a microscope. 

An objective must have enough angular aperture to 
delineate or resolve the smallest elements of any general 
image, so as to admit of their amplification, and the objec- 
tive (with eye pieces) must have refractive power enough 
(focal distance) to amplify the general image and images 
of the structural elements, so as to form a visual angle. 

Just what a visual angle is, I don't know, but it is said 
to represent the distance between two contiguous rods or 
cones in the fovea centrcdis. 

I have said that the average eye can see lines ruled on 
glass about 200 to the inch, or the eye can see structural 
elements in any object which have a size of 1-200 of an 
inch. Xow any object, big or little, which can hp seen by 
the eye, if it is made up of structural elements less than 
1-200 of an inch, these elements cannot be seen by the eye. 
If a house, or barn, or an elephant, is composed of struc- 
tural factors no larger than something smaller than the 
1-200 of an inch, these elements cannot be seen by the eye, 
any better than they can in any object a thousand times 
smaller, and the reason is that the angular aperture of the 
e^ye is not wide enough to permit these small things to be 
seen. If a microscopical house, composed of elements 1-200 



Original Communications. 469 

of an inch in size could be amplified by lenses which did 
not have an increased power of delineating small objects, 
it would make no difference how much the apprent size of 
the house was amplified, even up to 5,000 diameters, the 
structural elements of the house would yet be invisible. 

Now in looking at a diatom which has lines so clos© 
-together that the lines and spaces between them cannot be 
delineated or resolved by the objective which is being used 
on account of its narrow angular aperture, no amount of am- 
plification of the image of the diatom, by the objective and 
eye pieces, even up to 5,000 diameters, will make the lines 
on the diatom visible. But now if an objective, of greater 
or less magnifying power, be substituted, which has a suffi- 
cient angular aperature to delineate these lines and spaces, 
they can be seen, if the whole diatom is magnified only a 
few hundred dianleters, instead of 5,000. 

Magnifying or refractive power, then, or focal distance, 
is not the only factor necessary in an objective, though it 
was formerly thought to be. The popular idea is, even at 
the present time, that the power of the microscope has di- 
rect relations only to the magnifying power of the lenses, 
especially the objective. Objectives were formerly con- 
structed with narrow angular apertures, even when made 
with the highest amplifying power. The fact that an ob- 
jective was a 1-16, or a 1-20, was considered to be proof of 
its high power. This is only proof that it can amplify 
the image of a diatom a certain number of diameters, but 
is not proof that it can show the finer lines on a diatom, or 
other equally small elements in a general image which is 
magnified. Beal and Carpenter used objectives of 1-20 and 
even 1-50 inch focal distance, but with narrow^ angular 
aperture, and the fact has been since learned that objec- 
tives of 1-8, or 1-10 inch focal distance are far better instru- 
ments, providing they have wide angular apertures. Per- 
haps the best objective made and which reaches the limit 
of possibilities in the power of objectives is a 1-10 inch, 
having an extreme angular aperture of ISO deg. 

The reasons of this are evident from w^hat has been 
said, viz: that amplifying power belongs to eye pieces as 



470 The Peoria Medical Monihly. 

well as to objectives, and the further fact that an angular 
aperture of 180 cleg, reaches the limit of construction, and 
that lines or elements of structure of objects having a little 
less than 1-150,000 inch is the limit of the resolving power 
of objectives. 

The power of resolving lines and spaces between them, 
or other elemental structures or objects having the size of 
1-150,000 part of an inch is the work of that factor of an 
objective's power which is given by its angular aperture 
and not by its magnifying power. When these lines are 
resolved by the objective they must then be amplified by 
refractive lenses until they are large enough to form a vis- 
ual angle, and it is found that an amplification of 750 or 
1,000 diameters is sufiicient to do this work. A 1-10 ob- 
jective with a 1-inch eye piece will give these lines and 
spaces an amplification of 1,000 diameters, and therefore a 
1-10 objective, having an angular aperture of 180 deg, re- 
solving 150,000 lines to the inch (nearly), is the present 
limit of microscope construction, and represents all that 
eye pieces and objectives can do as aids to human vision. 

Now a 1-20 objective, having an angular aperture of 
180 deg, is no better than a 1-10 objective having the same 
resolving power or angular aperture for these reasons : If 
we have the 150,000 lines resolved by an objective, it is 
necessary to magnify them 1,000 diameters to see them. It 
is immaterial whether they are magnified with an objective 
or with an eye piece. If the objective is a 1-10, a 1-inch 
eye piece is required to magnify the image of the resolved 
lines to 1,000 diameters. If the objective is a 1-20, an 
eye piece of 2 inch focal distance is required. So there 
in no possible advantage in having a 1-20, or a 1-16, or a 
1-12, or even a 1-10 objective, for a 1-8 inch focal distance 
objective will do all the work that any objective can do, 
with the proper eye pieces. 

To magnify a resolved image to 1,000 diameters we 
can use either of the following combinations : 

inch eye piece. 



1-5 


inch 


objective, 


and 


1 


1-10 


kt 


(. 


a 


i 


1-20 


n 


a 


u 


2 



Original Communications. 471 

The character of the image which is magnified, so far 
as the number of lines per inch, or equally small objects, is 
concerned, will depend entirely upon the angular aperture 
of the 1-5 or 1-10, or the 1-20 inch objective which is used 
in this combination. Xow, of course, deeper eye jDieces 
may be used, and the image may be magnified up to per- 
haps 5,000 diameters, but this amplification will show 
nothing new in the image, it will only give greater dis- 
tinctness to the details, and lessen the extent of the field, 
or number of lines in the field. 

But not all objects which are looked at through the 
microscope contain 150.000 lines to the inch, or other ob- 
jects of equal size, nor an5^thing approaching it. In med- 
icine, or clinical use, lower power, and lower angular ob- 
jectives are ottener required than higher. The extreme 
angular apertures exhibit objects which are of course no 
wider than they are thick, and hence such objective does 
not have enough of what is called penetration to properly 
exhibit such objects. 

The rule is to use an objective with an angular aper- 
ture, and power no higher than is required to properly 
resolve and magnify the object. Using an objective of ISO 
deg. angular aperture on an object having only 300 lines 
to the inch, would be like using the telescope in the AVash- 
ington Observatory for an opera glass. It is evident, there" 
fore, that objectives having low magnifying power, and an- 
gular aperture are necessary in the microscope. Perhaps 
the following list will comprise a battery of objectives 
which will most satisfactorily cover the whole ground of 
microscopy : 

A 3 inch of 10 deg. angular aperture. 

u I i; u 25 '• " '' 

This list of objectives, with a set of eye pieces of two 
inch, one inch, one-half inch, and one-third and one-fifth 
.inches, will enable the microscopist to resolve any 
objects resolvable by objectives, and magnify them as 
much as there is any necessity for magnifying them. 



472 The Peoria Medical Monthly. 

The higher power objectives are made with a screw 
collar adjustment, which by aiDproximating the elements 
or lengthening the space between them, adapt the objec- 
tive to different conditions, which arise from using differ- 
ent fluids for immersion, and for various thicknesses of 
cover glasses. In such objectives there is no doubt but the 
screw collar is a necessity. Objects only 140,000 to the 
inch, or more or less, are difficult to focus, and cover 
glasses and other conditions may make it impossible to 
focus them. In lower powers, unless the angular aperture 
is very high, the screw collar is not a necessity. 

In purchasing a microscope, one of American make is 
generally preferable. 'The stands of medium size and 
weight, made by Bausch & Lomb, of Rochester, N. Y., or 
Tolles, of Boston, are excelled by no makers ; neither are 
their objectives. My own stand was made by Tolles, after 
plans devised by Dr. Geo. E. Blackham, and the low power 
objectives and one-eighth of ISO deg. were made by Bausch 
& Lomb. No doctor can get any good out of a poor 
microscope, for the reason that toys do not even amuse 
grown up people for any length of time. 



Akt. II.— Quackery. By Albro B. Allen, M. D., .Jerseyville, 111. 

Considerable has been said in various journals about 
quacks and quackery. Dr. King to my mind is to the 
point. Now why is it that these ignoramuses obtain busi- 
ness and a professional standing among the masses ? Sim- 
ply because the masses of the medical fraternity will not 
admit there is an honest, competent physician residing in 
the same town in which they are, other than themselves. 
He is the only surgeon, the only physician. He will expa- 
tiate at length on the mistakes made by others at various 
times, and wind up by saying he soon rectified it when he 
was called. Again he seeks out the father or mother where 
a child has died, expatiates upon his unprecedented success 
in the disease their child died of, as if he was totally ignor- 
ant of the cause of the death. Then very blandly apolo- 
gises, they are not to blame for the death of the child, they 
cannot be expected to be judges of the qualifications neces- 



Original Communications. 47S 

sary to practice medicine successfully, and so on ad injin- 
Hum. Now nearly all do this. And all had rather die than, 
acknowledge a superior in any branch of the profession; 
yet it is a well-known fact one man has a greater aiDtitude 
for one branch than for another, and it is but reasonable 
to suppose he will become more proficient in that branch 
and far more successful than his professional brother who 
may excel him in some other branch. Yet not one can be 
found to admit this self-evident fact. 

While it is true a man must be medicinally educated 
before he is capable of discerning between the relative 
merits of two or more physicians, it is equally true few^ are 
so ignorant that they cannot grasp the plausibility of the 
argument of equal competency professionally when the 
bickerings of even the so-called leaders are pointed out by 
the ignorant quack. Harvey, in his day, was denounced 
by the profession as a quack, so was Hunter, Bell, and 
others, and in fact all who arrive at distinction either from 
superior skill or extreme ignorance, and so has it been in 
all time. Before we can expect the masses of the people 
tc >^espect us we have first got to respect ourselves. The 
StauO Board has abolished quacks in this state. A man 
has first to be a graduate of an accredited school of med- 
icine before he can open out for business. He may be a. 
bright scholar, or just sufficiently intelligent to pass an ex- 
amination and receive a diploma. They are both physi- 
cians, and it now remains for each to apply his skill to 
the practical test of earning bread and butter. The scholar 
may conform to ethics, the latter will conform to business 
usages and get a large and lucrative business. Which is 
the success, the man who revels in fame and plenty of 
money or the rusty skill and starving dignity of the un- 
known and unrespected scholar ? In a profession a man's 
brains is his stock in trade, and what he wants is to sell it 
for what it will bring in the market. Put forth an effort 
and find buyers, plenty of them, who will pay a good price 
in cash. Make politicians bow at his shrine and legislate 
for his interest that they may secure his influence. It is 
time the medical profession had quit their bickerings 
among themselves and sought legislative enactments for 



474 The Peoria Medical Monthly. 

the securing of their fees and the financial and public re- 
spect of the profession at large. 

I think I know something about ignorant quacks and 
ethical gentlemen and (educated business irregular quacks). 
The latter are by the masses the most highly respected for 
skill and business energy. What does a sick man c^re or 
know about professional ethics ? Professional skill is what 
he wants, and the educated business quack gets his business 
because he has solicited it. Men in all departments like to 
do business with those who desire their patronage and give 
them what they want. 

I submit the above thoughts to the profession at large. 
They are my conclusions drawn from twenty-three years 
of close observation all over the central part of the United 
States. 

Art. III. — Foreign Bodies in the Bronchi Simulating Phthisis: Death From 
Hemhorrliage and Exhaustion. By H. Newell Sill, M. D., Strawbeny 
Point, Iowa. 

In December last I was called to see S. W., aged 24 
years. His weight was about ISO pounds. He had been a 
very healthy person all his lifetime until about September 
previous, when he began to complain of shortness of breath, 
a dry cough and expectoration of blood. Dr. Craig was 
called to prescribe for him, finding dullness on percussion 
in the subclavicular region over the right lung. The doc- 
tor believed the cause to have been traumatic, visited him 
a few times and prescribed such remedies as he judged ap- 
propriate. The patient had not been troubled with any 
perceptible inflamn:^toiy condition of the lung nor pleura ; 
had not even been confined to his room. When I first saw 
the case there was complete dullness covering the entire 
right lung as completely as though the right chest was en- 
tirely filled by the liver. Mensuration failed to reveal any 
expansion of that side, and no rules or murmurs were re- 
vealed to the ear even through the stethoscope. An attempt 
to speak would cause a cough tubular in character ; respi- 
ration about 24 ; pulse 20. I could not obtain any satis- 
factory point from which to start the difficulty as regards 
time and cause, and I looked upon the case as being quite 
grave. 



Original Communicatioxs. 475 

I began my treatment b}^ applying- a large blister on 
right side, and painting the remainder of the chest with tr. 
iodine, and giving expectorants, which appeared after a 
few days to cause an expectoration somewhat purulent and 
bloody, and I soon observed that air was penetrating the 
lung to some extent. About January 29, during a cough- 
ing paroxysm, he expelled a fragment of oat straw 
which w^as collapsed, coated, and measured one and one- 
fourth inches in length, also smaller fragments. On my ar- 
rival a few hours afterward I found him struggling for 
breath, pale, breathing above 40 per minute and the pulse 
I could not count. He appeared as though he must soon 
succumb, but in a few hours be began to rally and contin- 
ued to improve. The j'oung man remarked that there was 
another piece of straw in the other bronchus because it felt 
the same as did the right side. About January 31 he ex- 
pelled while coughing a piece of white hickory about one 
line in width and eleven lines in length which had a very 
sharp point, and was saturated with blood. February 1st 
my attention was called to the fact that he did not void 
sufficient urine. I introduced a catheter and drew off a 
small quantity which was heavily loaded, an analysis reveal- 
ing the fact that there was a large amount of urea in ex- 
cess which was soon manifested by uremic symptoms, strong 
and active, but elimination followed and our patient began 
to improve, and to all appearance was really convalescent,^ 
the cough nearly gone, respiration came to the no^;mal 
standard, pulse SO, and in about three weeks our patient 
was able to be about the yard, walking out to the ba.ru and 
feeling as though he would soon be at work. About Feb-, 
I'uary 23 he began to bleed from the right nostril, and oa 
the 25th I was called ; found the bleeding had continued, 
my subject pale, pulse rapid and weak, eyes bloodshot, and 
over his entire person from the feet to his head was the ap- 
pearance to the eye of an eruj)tion, but not to the feel. 
There was a complete giving away of the capillary system, 
and they ruptured, giving out their contents underneath 
the skin, countless in their numbers. By plugging the nose 
the hemorrhage ceased, but a slight delirium soon followed 
and on the 2Sth he expired. No post mortem. To me this 



476 The Peoria Medical Monthly. 

case is fraught with profound interest, while there is very 
much more connected with it that I do not understand, 
than there is that I do. 

Perhaps there may be some one wdio can enlighten me 
about the whole matter. If so, speak on, brother. 



Greasing with Fat Bacon for Scarlatina. By Silas Hubbaed, M. D., 

Hudson, 111. 

In the March number of this journal Dr. J. M. Hole 
gives his successful experience of treating scarlet fever 
with inunction of hog lard. I would say that for more than 
thirty -five years I have treated many cases ot scarlatina in 
part by frequently greasing the patient with fat bacon with 
satisfactory results. 

Dr. Merrill contended that the good effect of lard in- 
unction was that the fever spent itself upon the lard instead 
of the fat of the patient. I supposed that the good effects 
of the grease was either by killing the scarlatina bacteria 
or furnishing them food until they died a natural death. 

So far as I know my brain originated the supposition 
that scarlatina is an attack of millions of parasites on the 
human subject, and to fight them I greased the patient, 
and recently have in a number of cases given frequent 
small doses of sulphur moruing and evening to the well 
in the family afflicted with the disease, as a prophylactic. 
The patients recovered speedily, and the well did not take 
the disease, or had it lightly. 



Ustilago 3Iai(lis. By Silas Hubbard, M. D., Hudson, 111. 

I have in more than a dozen cases of tedious labor ad- 
ministered ustilago maidis, and for the same purpose I 
have in more than a hundred cases administered seeale 
cornutum, and will now deduce some of their differences of 
action. I have noticed that the secale cornutum generally 
produces one continued, persistent contraction of the uterus, 
while the ustilago maidis increases the power of action of 
the uteris and the frequency of its rhythmycal muscular con- 



Notes from Private Practice, , 477 

tractions, it does not prevent the rhythm of parturition; and 
thus though I never lost a patient or child in the adminis- 
tration of either remedy, I can fairly infer that secale cor- 
nutum is more dangerous to the life of the child than usti- 
lago maidis. On account of the ustilago maidis allowing 
of the alternate contraction and relaxation of the uterus, I 
find that it has no virtue in preventing or curing post par- 
turn or ante partum hemorrhage, and T have sometimes 
with good effect administered secale cornutum to cure post 
partum hemorrhage after having accomplished the deliv- 
ery by the aid of the ustilago maidis. I find that in cases 
of abortion without hemorrhage, when it is perceived that 
it cannot be prevented, that ustilago maidis is the best 
agent to hasten their completion. I find that although 
ustilago maidis has no virtue in curing ante partum or 
post partum hemorrhage, it is a very sure remedy for or- 
dinary menorrhoea. 



Ischio-Rectal Abscess. By Kathaeixe Miller, M. D., Lincoln, 111. 

Mrs. L., aged 45, general health good and functions in 
all respects normally performed, came to my ofiice* April 
IS, complaining of a deep-seated pain as if "' of a boil" in 
the sacral region, with which she had been troubled for 
about a week. On examination I found tenderness posterior 
to the rectum, both on pressure per rectum and externally 
on deep pressure. Inquiry showed that several months 
before Mrs. L. had fallen heavily on the buttocks and for 
several weeks afterward she had experienced considerable 
lameness in the sacral region on rising and sitting down, 
and recently she had been on her feet much more than 
usual. Had had haemorrhoids which, however had not 
been troublesome of late. One had burst and bled freely 
some time before, resulting in a cure, she thought. The 
walls of the rectum seemed somewhat relaxed, but no dis- 
tinct hgemorrhoidal masses w^ere to be felt. I prescribed 
a sedative and astringent injection, and rest in the recum- 
bent position. In the evening of April 20, was called to see 
Mrs. L. Found her suffering great pain of same character 
as before, not aggravated by going to stool. Bowels regu- 



478 The Peoria Medical Mois^thly. 

lar. Diagnosed ischio-rectal abcess. Gave opiate to pro- 
cure rest and ordered bowels freely moved by potass, bitart. 
April 21, found some swelling at right of anus. No urine 
had been passed for 24 hours, and on using the catheter 
but a small quantity was found in the bladder. In the 
afternoon of the same day lanced the abscess one inch to 
the right of and behind the anus. At a depth of 1^ inches 
reached a pus cavity which discharged about three ounces 
of dark-colored pus having a strong fgecal odor. Washed 
out the cavity and introduced a double drainage tube. Or- 
dered the cavity syringed twice daily with a weak carbol- 
ized solution. Still obliged to use catheter. Urine more 
freely secreted after the lancing of the abscess. April 22, 
in the evening, urine passed normally. Very slight dis- 
charge of good and laudable pus during the day. No fever. 
Appetite fair. Digestion good. April 23 and 24 Mrs. L. 
stood up several times to rest herself, and in her move- 
ments displaced the drainage tube. Water returned per- 
fectly clear on washing out the cavity. Patient felt well 
except some superficial soreness about the ppint of incision, 
which rapidly subsided. A week later she complained at 
times of a pain radiating dow^n the right thigh posteriorly, 
but this after recurring occasionally for a few weeks, grad- 
ually ceased, and she experienced no further trouble. 



Record of 200 Consecutive Obstetrical Cases. By L. L. Leeds, M. D., 
Lincoln, 111. 

Number of male children. 105. Number of female 
children, 95. Average duration of labor, 7 hours, 21 min- 
utes. Average duration of labor with male children, 7 
hours. 37 minute. Average duration of labor wdth female 
children, 7 hours, 3 minutes. Maximum duration of labor, 
24 hours. Mimimum duration of labor, i hour. Total 
number of hours of labor in 200 cases, 1490, or sixty-one 
days, six hours* Number born between low and high 
twelve, 97. Number born between high and low twelve, 
103. Number of primipariae, 51. Average duration of la- 
bor of primiparge, 8 hours, 17 minutes. Maximum dura- 
tion of labor of primiparse, 24 hours. Minimum duration 



Notes from Private Practice. 479 

■of labor of primiparge, 2 hours. Average duration of labor 
of multiparse, 7 hours, U minutes. Maximum duration of 
labor of multiparse, 22 hours. Minimum duration of labor 
of multiparge. A hour. 

In nine cases obstetrical operation was required. Cra- 
niotomy, 1 case, necessitated by hydrocephalus. Version, 
2 cases. Forceps. 6 cases, two of them necessitated by mal- 
formation, three by inertia, and one by failure of the moth- 
er's powers. Nationality of mothers : American, 121 ; Ger- 
man, 43 ; Irish, 19 ; English, 6 ; African, 5 ; Jewish, 4 ; 
Scotch, 1 ; Gipsy, 1. 



tf/Orreisiiotttlenre. 



The Card-Index— Contiuued. 

Chicago, III., March 25, 1883. 

Editor Peoria Medical Monthlij : 

Having received several inquiries concerning the card- 
index I described and recommended in the February num- 
ber of this periodical, I have thought it, advisable to give a 
more elaborate explanation of it through the same medium 
in which the original outline was published. 

There is nothing essentially original in my method of 
" preserving " the " fruits " of the labor of others for my fu- 
ture use. The card-index is not new\ It is used in most of 
the large libraries, and by many literary workers in special 
fields. But its sphere of usefulness is much broader than 
that which it is now made to fill, and for this reason its ad- 
vantages over all other methods of indexing should be more 
generally known and employed. 

A further description of the material part of the index 
is hardly required. But to begin at the beginning with the 
" details " wdiich I have been requested to fully set forth, 
I will repeat part of which has been already said. 

First, as to the cards. The size is not of great import- 
ance, but I have found that the ordinary postal card is a 
good pattern by which to have the cards cut. A brief account 
of the origin and evolution of my own index will probably 



4S0 The Peoria Medical Monthly. 

be a good guide to others. I had a paper-dealer cut one 
thousand cards to begin with, from unruled, well-sized pa- 
per. In thickness and stiffness, the covers of Peoria Med- 
ical Monthly correspond very nearly to the cards of my 
index. They had better be too light than too heavy, as 
they must be somewhat easily bent, so as to be readily ma- 
nipulated with the ends of the fingers when in position. 

These cards are set up rather loosely, edgewise, in a 
drawer in any writing desk, (which is also my reading desk). 
If they are packed too closely, the cards cannot be readily 
separated sufficiently to read the headings. 

The thousand blank cards were divided into lots, one 
corresponding to each letter of the alphabet, and the first 
card in each lot labeled with its proper letter on the free 
edge of a slip of paper pasted on the back of the card, the 
free edge extending half an inch above the cards. 

The blank cards were thus divided into lots, and all 
put in at first, so that each letter-division would be sepa- 
rated from the contiguous ones by a small distance, and the 
different letters, all readily seen, one not hiding another 
behind it. Of course, after the index has been in use for a 
time the letters will be separated in a ratio corresponding 
to the amount of matter indexed under each letter. When 
the first 1,000 cards were approi^riated, more were procured 
of the same size and quality. Obviously, they should cx- 
actli/ correspond in height (width), but the length is not of 
so great importance, the ends need not be always even. 

Perhaps the most appropriate receptacle for the cards 
is an open tray, made of wood or tin, divided into sections, 
the width of the sections being a trifle more than the length 
of the cards, so they may be easily inserted. 

The receptacle, however, as well as many of the details 
in the use of the index, may vary with the particular no- 
tions, needs and convenience of the owner. 

An editor or any person doing much " original " liter- 
ary work would find it more convenient to have a quadru- 
'ped-al tray with its hind legs the longest, like the kangaroo, 
to give the desired inclination. A printer's case possibly 
comes nearer to being a good model than the kangaroo, but 



COREESPONDENCE. 4S1 

either — mutatis mutandis — will give the carpenter an idea 
of what is wanted. This case, standing at the left of the 
writing-desk within easy reach, is quickly consulted and 
occup